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Bibliography on: Alzheimer Disease — Treatment

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Robert J. Robbins is a biologist, an educator, a science administrator, a publisher, an information technologist, and an IT leader and manager who specializes in advancing biomedical knowledge and supporting education through the application of information technology. More About:  RJR | OUR TEAM | OUR SERVICES | THIS WEBSITE

RJR: Recommended Bibliography 28 Aug 2026 at 01:38 Created: 

Alzheimer Disease — Treatment

Alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer's, symptoms first appear in their mid-60s. Alzheimer's is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. Scientists don't yet fully understand what causes Alzheimer's disease in most people. There is a genetic component to some cases of early-onset Alzheimer's disease. Late-onset Alzheimer's arises from a complex series of brain changes that occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer's may differ from person to person. Because of this lack of understanding of the root cause for Alzheimer's Disease, no direct treatment for the condition is yet available. However, this bibliography specifically searches for the idea of treatment in conjunction with Alzheimer's to make it easier to track literature that explores the possibility of treatment.

Created with PubMed® Query: ( alzheimer*[TIAB] AND treatment[TIAB] ) NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2026-08-27

Solfrizzi V, Lozupone M, F Panza (2026)

Anti-amyloid drugs: Integrated clinical pathways for treating older patients with frailty and dementia.

Ageing research reviews, 122:103331 pii:S1568-1637(26)00323-5 [Epub ahead of print].

The introduction of anti-amyloid therapies for Alzheimer's disease challenged current care models, particularly for older adults with frailty. The potential low efficacy of anti-amyloid drugs in these patients may be attributed to chronic inflammation, impaired repair mechanisms, and multisystem dysregulation. Neuropathological studies suggested that the accumulation of common brain pathologies may contribute to progressive physical frailty in older age. At present, there is no certified diagnostic-therapeutic pathway governing the management of patients eligible for anti-amyloid treatment, regardless of the presence of frailty. In the present view point, we argued that frailty should not be treated as an exclusion criterion for anti-amyloid therapies, but as a stratification dimension requiring integrated, multidimensional clinical pathways. Without embedding frailty assessment into eligibility, monitoring, and outcome evaluation, the real-world implementation of disease-modifying therapies risks being ineffective, inequitable, and ethically problematic. Here, we proposed to integrate frailty assessment with biological and neuroimaging criteria to promote ethical, equitable, and clinically-feasible access to disease-modifying treatments in real-world settings.

RevDate: 2026-08-27

Wright KA, Horta M, Hayes A, et al (2026)

Oxytocin as regulator of stress and inflammation in aging.

Neuroscience and biobehavioral reviews, 190:106924 pii:S0149-7634(26)00381-7 [Epub ahead of print].

Chronic stress and inflammation are potent determinants of negative health trajectories across adulthood, contributing to the progression of neurodegenerative diseases. In aging, these processes become increasingly intertwined, forming a feedforward loop in which chronic stress activates pro-inflammatory cascades in the brain and body, while pro-inflammatory cytokines stimulate stress-response pathways. Together, these interactions accelerate neuronal vulnerability, cognitive decline, and even Alzheimer's disease and Related Dementia (ADRD) pathology. The neuropeptide oxytocin (OT), a modulator of neurophysiological and social-affiliative processes, may buffer against stress and inflammation. There is evidence suggesting that OT dampens hypothalamic-pituitary-adrenal (HPA) axis reactivity, reduces pro-inflammatory cytokines, and promotes adaptive behaviors that restore physiological balance and promote healthy coping. OT can be synthetically produced and delivered via intranasal administration (IN-OT), providing a potential means of enhancing OT signaling. Understanding OT's role in aging, however, remains limited but of high relevance, also given the convergence of stress and inflammatory cascades in ADRD. This narrative review integrates previously distinct lines of research to delineate proposed pathways through which OT regulates stress and inflammation in aging and ADRD. Using systematic search strategies, this review also provides a structured synthesis of recent studies to evaluate evidence for IN-OT as a therapeutic for mitigating stress and inflammation, with discussion of its potential application in aging and ADRD. Research gaps and future directions are offered regarding OT's mechanisms of action, moderators of IN-OT's treatment response, and enhanced attention to midlife in IN-OT research on stress and inflammation in older adults as well as individuals with ADRD.

RevDate: 2026-08-27
CmpDate: 2026-08-26

Budson AE, Ljubenkov PA, Ritter A, et al (2026)

Considerations for using amyloid-targeting therapies for the treatment of early symptomatic Alzheimer's disease.

Frontiers in neurology, 17:1863897.

Amyloid-targeting therapies (ATTs), including donanemab and lecanemab, are FDA-approved disease-modifying therapies for Alzheimer's disease in the mild cognitive impairment or mild dementia stages. Early initiation is important for optimal outcomes. This article summarizes practical strategies for implementing ATTs in clinical practice, focusing on leadership alignment and infrastructure development, as well as patient identification, diagnosis, and monitoring protocols. Key recommendations include establishing appropriate patient tracking systems, infusion and imaging protocols, and interprofessional collaboration. Approaches for systematic patient routing (e.g., hub-and-spoke models, fast-track mechanisms) and biomarker-integrated assessments are critical to facilitating timely diagnosis and treatment. Education for patients, care partners, and clinicians is crucial for managing the risks associated with amyloid-related imaging abnormalities. Successful ATT implementation requires coordinated systems, timely diagnosis, and robust safety monitoring. These measures can enable frameworks for ATT administration to optimize outcomes for patients, care partners, and health systems.

RevDate: 2026-08-26
CmpDate: 2026-08-26

Jiang S, Sydney EJ, Runyan AM, et al (2026)

Correction: 5-HT4 receptor agonists treatment reduces tau pathology and behavioral deficit in the PS19 mouse model of tauopathy.

Frontiers in cellular neuroscience, 20:1945844.

[This corrects the article DOI: 10.3389/fncel.2024.1338502.].

RevDate: 2026-08-27
CmpDate: 2026-08-26

Shaik NS, Balya H, Ramamurthy S, et al (2026)

Evaluating the safety of investigational anti-Alzheimer's drugs: a comprehensive meta-analysis in the past to current decade.

Dementia & neuropsychologia, 20:e20250472.

UNLABELLED: Alzheimer's disease is a progressive illness that results in the degeneration of neurons with considerable burden. The pharmacological treatments for Alzheimer's disease include cholinesterase inhibitors, monoclonal antibodies, NMDA receptor antagonists despite having different adverse drug reactions (ADR) alongside the health benefits. Limited data exists for the complete safety evaluation across different classes of anti-Alzheimer's drugs.

OBJECTIVE: The meta-analysis evaluated the severity, frequency and variability of ADR as a result of Alzheimer's drugs to determine relative safety across various classes.

METHODS: This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with studies derived from the United States National Library of Medicine (PubMed), Embase, Scopus and ClinicalTrials.gov that focus on randomized controlled trials (RCTs) and observational studies which detailed ADRs of anti-Alzheimer's drugs. Jeffrey's Amazing Statistics Program (JASP) software was used to conduct heterogeneity assessment (I2), risk ratio (RR) and publication bias analysis in addition to meta-regression.

RESULTS: 31 studies were utilized. The studies with cholinesterase inhibitors exhibited more gastrointestinal ADRs and monoclonal antibodies exhibited amyloid-related imaging abnormalities (ARIA-H and E). The BACE1 inhibitors showed liver toxicity that led to increased patient drug discontinuation. A random-effects model was used for the analysis due to heterogeneity (I[2]>50%). The meta-regression analysis indicated drug class as a predictor for the type of ADR.

CONCLUSION: The research demonstrates considerable variations in the safety of Alzheimer's drugs that need tailored treatment supported by post-approval monitoring systems. The literature needs extended investigations of safety evaluation as well as practical treatment investigations in actual clinical settings. Unlike conventional reviews focusing solely on currently approved therapies, this study provides a cross-generational analysis of adverse drug reactions across both historical and investigational anti-Alzheimer's agents, offering insights into mechanism-related safety patterns that may inform the development and clinical use of emerging therapies.

RevDate: 2026-08-26

Brookfield N, Hauck PM, Doty EG, et al (2026)

Donanemab for early symptomatic AD in the UK-indicated population: safety and efficacy in those who are non-carriers or heterozygous for APOE ε4.

Neurodegenerative disease management [Epub ahead of print].

BACKGROUND: Licensing of donanemab in the United Kingdom (UK) for the treatment of early symptomatic Alzheimer's disease is limited to adults who are Apolipoprotein E (APOE) ε4 non-carriers or heterozygotes.

AIM: To assess safety and efficacy of donanemab in the UK-indicated population.

METHODS: Post-hoc analysis of APOE ε4 non-carriers or heterozygotes from a pooled TRAILBLAZER-ALZ and TRAILBLAZER-ALZ 2 population and the TRAILBLAZER-ALZ 2 population assessed safety and efficacy, respectively.

RESULTS: By 76 weeks, 13/825 (1.6%) and 170/816 (20.8%) participants in the placebo and donanemab arms experienced amyloid-related imaging abnormalities (ARIA)-edema/effusion, 96/825 (11.6%) and 218/816 (26.7%) participants experienced ARIA-microhemorrhages/superficial siderosis and 3/825 (0.4%) and 67/816 (8.2%) participants experienced infusion-related reactions, respectively. Donanemab significantly slowed disease progression versus placebo across multiple clinical scales, including a 40.3% (p < 0.0001) lower risk of progression to the next stage as measured by the Clinical Dementia Rating-Global score. Amyloid clearance occurred in 80.8% of donanemab-treated participants.

CONCLUSIONS: In the UK-indicated population, excluding APOE ε4 homozygotes reduced, but did not eliminate, ARIA risk with donanemab. Treatment slowed disease progression and reduced brain amyloid plaque by 76 weeks. Therefore, donanemab treatment requires structured risk-benefit discussion and appropriate monitoring.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT03367403, https://clinicaltrials.gov/study/NCT03367403 (TRAILBLAZER-ALZ) and NCT04437511, https://clinicaltrials.gov/study/NCT04437511 (TRAILBLAZER-ALZ 2).

RevDate: 2026-08-26

Jiyah A, Bulama I, Onu A, et al (2026)

Turmeric nanovesicles loaded with vitamins C and E attenuate oxidative stress and improve cognitive outcomes in rats with memory deficits.

Therapeutic delivery [Epub ahead of print].

AIM: Oxidative stress (OS) contributes to Alzheimer's disease (AD) pathology. Vitamins C and E target OS, but their efficacies are limited by poor intracellular delivery. Encapsulation in nanovesicles (NVs) may improve targeted delivery for AD treatment.

METHODS: Forty-five rats were randomly assigned to nine groups (n = 5 per group): normal control, scopolamine control, vitamin C, vitamin E, vitamin C + E, turmeric NVs (TNV), TNV-C, TNV-E, and donepezil. Treatment was administered intraperitoneally (IP) for one week before induction of the AD-like model using daily IP administration of scopolamine and continued for two weeks. During this time, behavioral activities were conducted, and brain tissues were collected for analysis.

RESULTS: Vitamins C and E showed encapsulation efficiencies of 12.36 ± 1.01% and 55.24 ± 5.82%, with loading capacities of 14.34 ± 1.37% and 40.70 ± 3.52, respectively. TNV-C and TNV-E increased brain levels of vitamins E and C, enhanced antioxidant defense and cognitive abilities, and reduced acetylcholinesterase activity in dementia rats. TNV-C and TNV-E also protected against neuroinflammation and neuritic plaque formation. Vitamin-loaded TNVs were more effective than free vitamins in improving antioxidant status and cognitive outcomes in AD rats.

CONCLUSION: This study highlights the potential of vitamin-loaded NVs as therapeutics for AD.

RevDate: 2026-08-26
CmpDate: 2026-08-26

Hendrix S, Mallinckrodt C, Abschneider RM, et al (2026)

Estimating treatment effects in clinical studies of Alzheimer's disease: What are estimands and why do we need them?.

Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(8):e71676.

In clinical studies, it is scientifically important, and a regulatory expectation, that objectives be translated into key clinical questions by specifically defining treatment effects to be estimated. Estimands are part of a structured framework, as presented in International Council for Harmonisation (ICH) E9(R1), by which study objectives are linked to a suitable study design and tools for estimation. Estimands are constructed using five attributes: treatment, population, variable (or endpoint), population-level summary for the variable, and intercurrent events (ICEs). ICEs occur after treatment initiation and can affect the existence or interpretation of the measurements. In Alzheimer's disease (AD), potential ICEs include additional AD medication use, discontinuation of treatment, and death. We describe estimands in recent clinical studies of anti-amyloid therapies, including gantenerumab, lecanemab, and donanemab, in AD and use the evoke and evoke+ studies of semaglutide in early-stage symptomatic AD as examples of estimand application in AD trials.

RevDate: 2026-08-26
CmpDate: 2026-08-26

Gao F, Liu L, Li J, et al (2026)

Overview in Electrochemical and Electrical Biosensors for Determining Blood Protein Biomarkers of Alzheimer's Disease.

Biosensors, 16(8):.

Early diagnosis of Alzheimer's disease (AD) can facilitate the establishment and implementation of therapeutic interventions. The currently used diagnosis methods for AD mainly include cerebrospinal fluid analysis and positron emission tomography imaging. Due to their high invasiveness, high cost, and limited accessibility, these technologies are difficult to meet the needs of large-scale population screening, grading diagnosis, and treatment, thereby limiting the popularization of early diagnosis of AD. The detection of blood biomarkers has become an important breakthrough in early screening and diagnosis of different diseases due to its non-invasive, low-cost, and easy-to-operation advantages. Recently, blood proteins such as amyloid-beta (Aβ), total and phosphorylated Tau, light chain neurofilaments (NFL), and glial fibrillary acidic protein (GFAP) have been considered promising biomarkers for the diagnosis of AD. However, there is currently no effective, minimally invasive, and easily accessible detection method for clinical diagnosis and risk prediction of AD. Electrochemical and electrical biosensors are highly sensitive, simple, fast, and cost-effective analytical tools for disease monitoring, drug development, and target detection. In this work, we comprehensively and systematically overview the progress of various electrochemical and electrical techniques for determining AD-related blood protein biomarkers, mainly including electrochemistry, electrochemiluminescence, photoelectrochemistry, quartz crystal microbalance, field-effect transistor, and organic electrochemical transistor. This work can provide guidance for researchers to develop novel electrochemical and electrical biosensors for early and accurate diagnosis of AD.

RevDate: 2026-08-26
CmpDate: 2026-08-26

Saitta A, Basilotta R, Lanza M, et al (2026)

Isoserine Improves Spatial Memory and Remodels Synaptic and Inflammatory Gene-Expression Programs in APP/PS1 Mice.

Cells, 15(16):.

Synaptic dysfunction is a major contributor to cognitive decline in Alzheimer's disease (AD) and represents an attractive therapeutic target. Here, we investigated whether chronic isoserine treatment improves cognition and alters the expression of synaptic-related genes in APP/PS1 mice. Isoserine was well tolerated and did not adversely affect body weight. In the Morris water maze, isoserine improved probe-trial performance in APP/PS1 mice, significantly reducing latency to the first platform-location crossing, while time spent in the target quadrant showed a directionally consistent but non-significant increase. To identify molecular correlates, we profiled 84 synaptic-related genes using a targeted RT[2] Profiler PCR Array. Gene-level factorial analyses identified several nominal treatment-associated effects, but no individual isoserine effect in APP/PS1 mice remained significant after false-discovery-rate correction. In contrast, module-level analyses identified False-discovery rate (FDR)-significant changes in NF-κB/inflammatory, synaptic-maintenance, and glutamatergic-signaling gene-expression modules, with significant genotype × treatment interactions for the NF-κB/inflammatory and synaptic-maintenance modules. Exploratory heatmap and principal component analyses further illustrated disease-context-dependent expression patterns. Western blot analyses showed that isoserine reduced nuclear factor kappa B (NF-κB p65) and NMDA receptor subunit GluN2B (GluN2B) and increased postsynaptic density protein 95 (PSD-95) levels in APP/PS1 mice. These findings suggest that isoserine improves spatial memory retention and coordinately remodels synaptic and inflammatory molecular programs in APP/PS1 mice.

RevDate: 2026-08-26
CmpDate: 2026-08-26

Wu Z, N Kong (2026)

Exosomes: Mechanisms, Diagnosis, and Therapeutic Progress in Vascular Cognitive Impairment.

Molecular neurobiology, 63(1):.

Vascular cognitive impairment and dementia (VCID) is a cognitive impairment syndrome triggered by cerebrovascular lesions and their associated risk factors, representing the second most prevalent cognitive disorder after Alzheimer's disease (AD). Currently, there are no disease-modifying therapies available for VCID. In recent years, significant progress has been made in the study of exosomes in the context of neurodegenerative diseases (NDs). Given the shared pathophysiological features and underlying heterogeneity between VCID and neurodegenerative disorders, it is hypothesized that exosomes may play a critical role in the pathogenesis, diagnosis, and treatment of VCID. This review systematically summarizes recent advances in the study of exosomes in VCID, elaborates on the potential mechanisms by which exosomes influence the onset and progression of VCID, and highlights their promising applications in the diagnosis and treatment of the condition. In conclusion, exosome-based research offers novel perspectives and strategies for the clinical diagnosis and intervention of VCID, potentially leading to more effective options for affected patients.

RevDate: 2026-08-27
CmpDate: 2026-08-26

Calabrò RS, Calderone A, Ravi D, et al (2026)

Hospital-to-Home Neurological Transition Care: A Scoping Review Across Selected Chronic Neurological Disorders.

Medical sciences (Basel, Switzerland), 14(4):.

BACKGROUND: Returning home after neurological hospitalization, rehabilitation, or specialist care transfers responsibility to patients, caregivers, and community services. We mapped mechanisms and gaps across dementia/Alzheimer's disease and related dementias (ADRD), Parkinson's disease (PD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS).

METHODS: Following JBI guidance and PRISMA-ScR, eligibility was derived using population-concept-context. We included empirical reports involving adults with a target condition, a post-discharge, return-home, rehabilitation, telehealth, caregiver, treatment, respiratory, or palliative continuity component, and post-transition patient, caregiver, service, safety, rehabilitation, equity, or implementation outcomes. Five databases were searched through to 11 May 2026. Two reviewers independently screened records; charting and classification were verified by R.S.C., A.C., and A.Q.

RESULTS: Of 24,417 records, 69 reports were included: Dementia/ADRD, 28; PD, 10; MS, 9; and ALS, 22. Eighteen were core transition reports (26.1%), 14 return-home/community re-entry reports (20.3%), 16 adjacent continuity reports (23.2%), and 21 companion/secondary reports (30.4%). Dementia/ADRD provided discharge-anchored evidence; PD and MS mapped functional carry-over; ALS mapped adjacent respiratory, telehealth, and palliative continuity.

CONCLUSIONS: The main contribution is an operational cross-disease framework separating direct discharge, return-home, adjacent-continuity, and companion evidence while linking mechanisms to disease-specific pathways. This framework maps disease-specific functions, not comparative effectiveness. The proposed frameworks are author-derived and hypothesis-generating. Future studies should use explicit anchors, standardized outcomes, longer follow-up, and equity-sensitive implementation measures addressing caregiver workload, digital access, feasibility, and sustainability. They inform testable, context-sensitive intervention designs for future neurological transition-care research and practice.

RevDate: 2026-08-26

Shi K, Luo XY, Liu TT, et al (2026)

Cerebral amyloid-β burden and white matter injury: associations, clues for underlying mechanisms, and implication on cognitive trajectory after lecanemab therapy.

Journal of advanced research pii:S2090-1232(26)00689-2 [Epub ahead of print].

INTRODUCTION: White matter hyperintensities (WMH) are linked to cognitive decline and risk of Alzheimer's disease (AD).

OBJECTIVES: To test whether amyloid-β (Aβ) deposition contributes to white matter injury and whether WMH dynamics can modulate the clinical efficacy of the anti-Aβ therapy.

METHODS: Twenty patients with early AD who are receiving lecanemab and a matched cohort of 110 untreated AD patients were followed. Linear mixed-effects models were used to examine the interplay between WMH trajectories and lecanemab on cognitive decline. The roles of Aβ burden in predicting baseline severity and progression rates of WMH were evaluated in a larger cohort of 1,031 adults. Finally, cerebrospinal fluid (CSF) proteomic and bioinformatic analyses were performed to identify potential candidate mediators and pathways linking Aβ to WMH progression.

RESULTS: Following lecanemab treatment (median = 13 times), 80 % of patients showed WMH reductions, predominantly in periventricular and frontoparietal regions. Compared to the reference cohort, WMH progression is significantly slower among those with anti-Aβ therapy. WMH trajectory significantly modified the relationship between anti-Aβ therapy and cognitive decline, with greater cognitive improvement observed among those with smaller WMH reductions. The levels of Aβ burden were correlated with higher burden and accelerated rates of WMH. Eight proteins in CSF were identified as candidate mediators linking WMH to Aβ. They were enriched in vascular-endothelial, neuro-cytoskeletal, and neuroinflammation pathways.

CONCLUSION: The interplay of Aβ with white matter integrity contributes to cognitive decline in the context of Alzheimer's disease.

RevDate: 2026-08-27
CmpDate: 2026-08-27

Zhou Y, Diao Y, Yan Z, et al (2026)

Development of a Novel AAV-Mediated microRNA Gene Therapy for Spatial Suppression of BACE1 to Improve Cognitive Function in Alzheimer's Disease Model Mice.

Biomolecules, 16(8): pii:biom16081075.

The beta-site amyloid precursor protein (APP)-cleaving enzyme 1 (BACE1) is a promising and rational target for Alzheimer's disease (AD), but current clinical trials have been disappointing. Consequently, utilizing the intrinsic regulatory mechanisms of BACE1 during AD pathogenesis might provide valuable insights into the treatment of this devastating disease. In this study, we proposed a combination of AAV delivery and microRNA therapeutics targeting AD at its root by sustained and spatial inhibition of BACE1 with a single therapeutic injection. We demonstrate that upregulation of BACE1 is correlated with downregulation of miR-143-3p in the hippocampus of individuals with AD, and miR-143-3p can directly target BACE1 to inhibit Aβ generation. In the brains of 5×FAD model mice, BACE1 levels are found to be elevated with age in the cornu ammonis 1 (CA1) subfield of the hippocampus. AAV-mediated miR-143-3p restoration in the hippocampal CA1 subfield of AD mice can improve cognitive performance, attenuate BACE1 expression, reduce Aβ levels, induce microglia polarization toward the anti-inflammatory phenotype, modulate neural-related genes including Gal3, and promote synaptic functions. Collectively, the AAV-mediated microRNA gene therapy approach developed for spatial suppression of BACE1 can effectively enhance cognitive performance in AD model mice, offering an attractive therapeutic option for AD treatment with long-lasting efficacy.

RevDate: 2026-08-27
CmpDate: 2026-08-27

Heath S, Ruzicka M, McLoon T, et al (2026)

The Role of the NMDA Receptor in the Treatment of Psychiatric and Neurological Diseases.

Brain sciences, 16(8): pii:brainsci16080786.

The N-methyl-D-aspartate receptor (NMDAR) is an ionotropic glutamate receptor widely expressed in the CNS and in peripheral tissues where it mediates crucial physiological functions and its dysregulation has been linked to a host of neurological and psychiatric disorders including Alzheimer's disease, schizophrenia, epilepsy, and chronic pain. This work highlights the therapeutic potential in targeting the NMDAR in these disease states by providing a holistic analysis of the existing literature focused on the molecular role of the receptor in applicable disease conditions. While several drugs targeting the NMDAR have been approved for clinical use, many more are in clinical and preclinical development. A significant part of this review assesses the chemical and pharmacological attributes of these molecules and provides a prognostic perspective for their use.

RevDate: 2026-08-24

Du L, Yan S, Ren X, et al (2026)

Breaking Alzheimer's Disease Barrier: The Role of Xanthoceras sorbifolia Bunge Oil in Gut-Brain Axis and TLR4/Myd88/MAPK Pathway Inhibition.

Phytotherapy research : PTR [Epub ahead of print].

Alzheimer's disease (AD) is a progressive neurodegenerative disorder associated with cognitive decline and neuroinflammation. Xanthoceras sorbifolia Bunge oil (XSBO), a woody plant oil rich in bioactive fatty acids, has shown potential health benefits. This study aimed to investigate the neuroprotective effects and underlying mechanisms of XSBO in AD. A scopolamine-induced AD rat model was established to evaluate the effects of XSBO on cognitive function, pathological changes, and neuroinflammation. Gut microbiota alterations were analyzed by 16S rDNA sequencing. Fecal microbiota transplantation (FMT) and short-chain fatty acid (SCFA) supplementation experiments were performed to explore the role of gut microbiota-derived metabolites. The TLR4/MyD88/MAPK signaling pathway was further examined. XSBO treatment improved cognitive deficits, reduced neuronal damage and neuroinflammation, and enhanced intestinal barrier integrity in AD rats. XSBO restored gut microbiota dysbiosis and increased SCFA-producing bacteria. FMT and SCFA supplementation confirmed that microbiota-derived metabolites contributed to XSBO-mediated cognitive improvement and neuroprotection. Mechanistically, XSBO inhibited lipopolysaccharide-induced neuroinflammation by suppressing TLR4/MyD88/MAPK signaling activation. XSBO alleviates AD-related cognitive impairment and neuroinflammation by modulating the gut microbiota-SCFA axis and inhibiting TLR4/MyD88/MAPK-mediated inflammatory responses. These findings suggest that XSBO may serve as a promising dietary intervention for neurodegenerative disease management.

RevDate: 2026-08-24
CmpDate: 2026-08-24

Gönüllü S, Dalkılınç E, Çelik O, et al (2026)

Therapeutic Effects of miR-29b-Enriched Nanovesicles on Mitochondrial Injury and Neuroinflammatory Processes in Alzheimer's Disease.

Neurotoxicity research, 44(5):.

Alzheimer's disease (AD) is defined by the accumulation of extracellular amyloid-β plaques and intracellular neurofibrillary tangles, which drive neuronal and synaptic impairment. In AD, the accumulation of protein aggregates leads to neuroinflammation, increased oxidative stress, and mitochondrial damage, resulting in neuronal loss and cognitive impairment. Emerging evidence highlights that microRNAs (miRNAs) modulate AD-related pathological pathways and may offer opportunities for therapeutic intervention. In this study, we investigated the therapeutic potential of microRNA-29b (miR-29b) delivered via small extracellular vesicles (sEVs) in an in vitro neuroblastoma model of AD. Four experimental groups were established using SH-SY5Y neuroblastoma cells: (1) untreated control cells, (2) Aβ-treated cells to model AD-like pathology, (3) cells treated with unloaded sEVs, and (4) cells treated with miR-29b-loaded sEVs (sEV-miR-29b). To evaluate treatment effects, we assessed markers of oxidative stress (ROS, LDH, SOD, MDA, GPX1), neuroinflammation (BDNF, ICAM1, TNF-α, NfL, MIF, VEGFA, MCP-1), mitochondrial dysfunction (Cytc, TFAM, PINK1, DNM1L), synaptic integrity (CPLX2, ROR1), and AD pathology (Amyloid-β, Total Tau, pTau181, pTau217). Our findings demonstrate that treatment with sEV-miR-29b attenuated Aβ-induced oxidative stress, reduced pro-inflammatory signaling, and improved mitochondrial homeostasis compared with Aβ-only and sEV-only groups. Moreover, sEV-miR-29b treatment partially restored synaptic protein expression and decreased pathological tau phosphorylation. These results indicate that miR-29b plays a regulatory role in neuroinflammation, oxidative stress, and mitochondrial function, suggesting that sEV-mediated delivery of miR-29b represents a promising therapeutic strategy for modulating AD-related neurodegenerative mechanisms. This study highlights the potential of miR-29b-loaded sEVs as a therapeutic approach for AD.

RevDate: 2026-08-26
CmpDate: 2026-08-24

Nasir AB, Kilani Y, Aldiabat M, et al (2026)

Antidiabetic medications and risk of cognitive disorders in type 2 diabetes: A retrospective cohort study.

PloS one, 21(8):e0356138.

OBJECTIVE: To evaluate the associations between commonly used antidiabetic regimens and incidence of mild cognitive disorder, Alzheimer disease, and vascular dementia in adults with type 2 diabetes.

This retrospective cohort study used the TriNetX US Collaborative Network of electronic health records from 2010 to 2024. Adults aged 40-69 years with type 2 diabetes and at least 1 year of follow-up were included. Propensity score matching was applied to balance covariates.

EXPOSURE: Patients were classified into 5 treatment groups: metformin only (reference), metformin plus DPP-4 inhibitors, metformin plus GLP-1 receptor agonists, metformin plus SGLT-2 inhibitors, and insulin monotherapy. Exposure was defined by first recorded prescription and continued use during follow-up.

MAIN OUTCOMES AND MEASURES: Primary outcomes were incident mild cognitive disorder, Alzheimer disease, and vascular dementia, identified using ICD-10 codes. Hazard ratios with 95% confidence intervals were estimated from Cox proportional hazards models, with landmark analyses for follow-up shorter and longer than 5 years.

RESULTS: Among 1,528,885 adults with type 2 diabetes (mean age, 58 years; 49.2% women), GLP-1 receptor agonists plus metformin were associated with lower incidence of vascular dementia (HR, 0.46; 95% CI, 0.37-0.57), mild cognitive disorder (HR, 0.79; 95% CI, 0.66-0.95), and Alzheimer disease (HR, 0.46; 95% CI, 0.31-0.70). SGLT-2 inhibitors plus metformin reduced vascular dementia risk (HR, 0.68; 95% CI, 0.54-0.87) but not other outcomes. Insulin monotherapy was associated with higher incidence of vascular dementia (HR, 3.27; 95% CI, 3.03-3.52), mild cognitive disorder (HR, 1.71; 95% CI, 1.56-1.87), and Alzheimer disease (HR, 1.56; 95% CI, 1.32-1.84).

CONCLUSIONS AND RELEVANCE: GLP-1 receptor agonists and SGLT-2 inhibitors combined with metformin were associated with reduced risk of cognitive decline. Insulin monotherapy was associated with higher incidence of all three outcomes; however, this association is likely influenced by confounding by indication, unmeasured markers of diabetes severity (including diabetes duration, cardiovascular and renal disease severity, and microvascular and macrovascular complications), and shorter follow-up among insulin users, and should not be interpreted as a direct drug effect. Because standard Cox models do not account for death as a competing event, reported hazard ratios reflect cause-specific hazards and may not directly correspond to cumulative incidence, particularly for the insulin group, in which mortality and censoring were substantially higher. Antidiabetic medication choice may influence long-term cognitive outcomes and should be considered in diabetes management.

RevDate: 2026-08-24
CmpDate: 2026-08-24

Chen H, Mcintyre MK, Aktay S, et al (2026)

Endovascular thrombectomy versus medical management in patients with dementia and acute ischaemic stroke.

Age and ageing, 55(8):.

OBJECTIVE: While pre-existing dementia is a known negative predictor for good endovascular thrombectomy (EVT) outcomes, comparative efficacy and safety data of EVT versus best medical management (BMM) for large vessel occlusion (LVO) patients with dementia are limited. This study compares hospitalisation outcomes of EVT versus BMM for LVO patients with underlying dementia.

METHODS: Using the US Nationwide Readmissions Database from 2016 to 2022, we retrospectively identified adult patients with dementia who presented with LVO stroke. The primary outcome was discharge to home. Secondary outcomes included in-hospital mortality, length-of-stay and complications. Patients who underwent EVT were compared to those who received BMM after propensity score matching. Interaction and subgroup analyses assessed treatment effect heterogeneity associated with age and dementia type.

RESULTS: Among 37 298 patients included, 6618 EVT and 13 092 BMM patients remained after propensity score matching. Home discharge rates were similar between groups (27.1% vs 26.4%, P = .51). EVT was associated with longer length-of-stay (median 7 vs 6 days, P < .001) and increased intracranial haemorrhage (23.9% vs 11.1%, P < .001), with no significant difference in mortality (15.0% vs 14.9%, P = .87). Patient age significantly moderated EVT effectiveness (interaction P < .001), and EVT among patients <75 years old was significantly associated with higher rates of home discharge (36.7% vs 26.8%, P < .001). Additionally, EVT appeared more effective for patients with vascular dementia (vs Alzheimer's disease, interaction, P = .014), among whom EVT was associated with significantly higher rates of home discharge (32.7% vs 25.2%, P = .007).

INTERPRETATION: Treatment response to EVT among LVO stroke patients with dementia was heterogeneous, and EVT was beneficial for patients <75 years old and those with vascular dementia.

RevDate: 2026-08-24
CmpDate: 2026-08-24

Ranganathan M, Jakob S, Cerrato F, et al (2026)

Schizophrenia Spectrum Biomarkers Consortium: Establishment of a Biorepository for the Discovery of Quantitative Fluid Biomarkers.

Schizophrenia bulletin, 52(5):.

BACKGROUND AND HYPOTHESIS: Schizophrenia spectrum disorders (SSDs) produce severe symptoms, disability, and premature mortality, but only partially effective symptomatic treatments exist. Treatment development is impeded by lack of insight into disease mechanisms or objective biomarkers for clinical trials. Advances in genetics and neurobiology have converged on strong pathogenic hypotheses for SSDs centered on synapse dysfunction and excessive pruning, pathogenic processes that may produce measurable proteomic evidence in cerebrospinal fluid (CSF). Leveraging design precedents from successful fluid biomarkers discovery for Alzheimer's disease, we undertook a pilot study to test the feasibility of repeated CSF and blood samples collection from individuals with SSDs. Here we report on successful implementation of longitudinal bio-behavioral phenotyping in SSDs and establishment of a repository to permit broad sample and data sharing.

STUDY DESIGN: The Schizophrenia Spectrum Biomarkers Consortium (SSBC) study principles included longitudinal study design, paired CSF and plasma collection associated with robust phenotypic characterization, at 3 academic sites and the establishment of a biorepository. Participants underwent clinical and cognitive assessments, neuroimaging, blood draws, and CSF collection via lumbar puncture (LP) every 6 months.

STUDY RESULTS: SSBC successfully enrolled 48 SSD and 41 Healthy Controls with a 73% longitudinal retention. Clinical, cognitive, and neuroimaging results were consistent across sites and with existing studies. Study procedures were well tolerated, and almost all LPs (99%) resulted in either no or minor headache/backache that resolved without medical interventions.

CONCLUSIONS: The pilot SSBC study demonstrates that a multi-site, longitudinal study with repeat CSF collection is feasible, with excellent participant acceptability and retention.

RevDate: 2026-08-25
CmpDate: 2026-08-25

Li X, Zhou Q, Ding S, et al (2026)

Shape-Based Partially Linear Single-Index Cox Model for Alzheimer's Disease Conversion.

Statistics in medicine, 45(20-22):e70708.

Alzheimer's disease (AD) is the major cause of dementia in the elderly, and characterizing the time to conversion to AD is crucial in preventative treatment. While existing statistical methods have proven effective in modeling AD conversion involving various clinical, genetic, and neuroimaging predictors, limited research has explored scenarios where these predictors are shapes derived from the shape space, a nonlinear Hilbert space. In addition, the linear relationship assumption in existing methods may be violated, leading to substantial efficiency losses in real-world applications. To address these challenges, we propose a shape-based partially linear single-index Cox (SPLS-Cox) model that accommodates both scalar and shape predictors. This new development is motivated by establishing the likelihood of conversion to AD in 372 patients with mild cognitive impairment (MCI) enrolled in the Alzheimer's Disease Neuroimaging Initiative, leveraging the early shape-based markers of conversion extracted from the brain white matter region, corpus callosum (CC). These 372 MCI patients were followed over 48 months, during which 161 progressed to AD. Our SPLS-Cox model establishes both the estimation procedure and the pointwise confidence band. Simulation studies are conducted to evaluate the finite-sample performance of our SPLS-Cox. The real application reveals that the CC contour shape is a significant predictor for AD conversion.

RevDate: 2026-08-25

Najmi AK, Yaduvanshi D, Aggarwal R, et al (2026)

Targeting the NLRP3 inflammasome pathway associated with neuroinflammation mediated Alzheimer's disease: pre-clinical and clinical status of emerging therapeutics.

Expert opinion on therapeutic targets [Epub ahead of print].

INTRODUCTION: Alzheimer's disease (AD) is a rising global health problem, but current treatments only target symptoms rather than fixing their underlying root causes. A major pathological feature is neuroinflammation, which is specifically driven by the Nucleotide-binding domain, Leucine-rich-repeat and Pyrin domain-containing 3 (NLRP3) inflammasome cascade, which acts as a 'molecular switch' that causes immune cells in the brain to trigger robust secretion of pro-inflammatory cytokines (e.g. IL-1β, IL-18) and pyroptosis, causing systemic inflammation, thereby the neuroinflammation.

AREAS COVERED: This review breaks down the pathways triggered by immune cells activation (neurotoxic microglial phenotype) and majorly focusing over the NLRP3 inflammasome neuroinflammation pathway. It explores the promising therapeutic potential of specific bioactive phytochemicals, repurposed and novel synthetic drugs/agents, to shut-down this molecular switch i.e. NLRP3 inflammasome pathway.

EXPERT OPINION: To truly stop AD, we must shift our focus from treating merely the symptoms, by stopping the disease at its roots. While discovering the novel NLRP3 inflammasome inhibitors is exciting, but the biggest hurdle is getting them into the brain. Future of AD treatment relies on combining these targeted drugs with advanced nanotechnology, like nano-particles, to successfully cross the blood-brain barrier (BBB) and safely deliver the drugs exactly where they are needed.

RevDate: 2026-08-25
CmpDate: 2026-08-25

Morató X, Hinojosa-Calleja A, Jofresa S, et al (2026)

When treatment becomes risk: polypharmacy and inappropriate prescribing in cognitive impairment in 2379 consecutive patients from a memory clinic.

Alzheimer's & dementia : the journal of the Alzheimer's Association, 22(8):e71708.

BACKGROUND: Polypharmacy, potentially inappropriate medications (PIMs), and drugs associated with drug-induced cognitive impairment (DICI) are highly prevalent in older adults and may affect cognitive decline.

METHODS: This observational retrospective study included 2379 patients evaluated at Ace Alzheimer Center Barcelona. Medication data were extracted from electronic health records using a large language model (LLM). Polypharmacy (≥5), hyperpolypharmacy (≥10), PIMs, and DICI drugs were analyzed across cognitive stages, Alzheimer's disease biomarkers, ApoE subtype, and estimated glomerular filtration rate.

RESULTS: Among patients with cognitive impairment (Clinical Dementia Rating [CDR] ≥ 0.5), 67% presented polypharmacy and 21% hyperpolypharmacy. Higher odds of polypharmacy were observed across the CDR scale, while higher education showed a protective effect. Altered renal function was found in 20.8% of patients with polypharmacy. Indeed, significant differences were found between amyloid beta-positive and negative (Aβ[+]/Aβ[-]) subjects and between the whole population and subjects participating in clinical trials.

DISCUSSION: Polypharmacy is extremely common in patients attending memory clinics. LLMs could facilitate systematic structured medication reviews.

RevDate: 2026-08-25

Pereira da Silva AM, Santos do Nascimento MDV, Menegucci G, et al (2026)

Pioglitazone and Cognitive Outcomes in Mild Cognitive Impairment and Alzheimer Disease: A Systematic Review and Meta-Analysis of Randomized Trials.

Alzheimer disease and associated disorders pii:00002093-990000000-00215 [Epub ahead of print].

BACKGROUND: Cognitive impairment is increasingly recognized among older adults with metabolic disorders, including type 2 diabetes. Metabolic dysfunction and insulin resistance have been implicated in neurodegenerative processes. Pioglitazone, an insulin-sensitizing agent widely used in the treatment of type 2 diabetes, has been investigated for potential effects on cognitive outcomes. This systematic review and meta-analysis evaluated the efficacy and safety of pioglitazone on cognitive outcomes in individuals with mild cognitive impairment or Alzheimer disease.

METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched through July 2025 for randomized controlled trials comparing pioglitazone with placebo in adults with mild Alzheimer disease or mild cognitive impairment. Cognitive outcomes included the Mini-Mental State Examination, the Wechsler Memory Scale-Revised, and the Alzheimer's Disease Assessment Scale-Cognitive subscale. Safety outcomes included adverse events, serious adverse events, treatment discontinuation, and peripheral edema. Random-effects meta-analyses were conducted using frequentist and Bayesian approaches.

RESULTS: Six randomized trials, including 3680 participants, were analyzed. Pioglitazone was not associated with differences in Mini-Mental State Examination or Wechsler Memory Scale-Revised scores compared with placebo. Alzheimer's Disease Assessment Scale-Cognitive subscale estimates modestly favored pioglitazone, although this finding was not consistent across other cognitive measures. Overall, adverse events and serious adverse events were similar between treatment groups. Treatment discontinuation occurred less frequently with pioglitazone. Peripheral edema was reported more frequently with pioglitazone, although estimates were based on a small number of events and wide CIs.

CONCLUSION: Pioglitazone was not associated with consistent differences in global cognitive outcomes in individuals with mild cognitive impairment or Alzheimer disease. Safety outcomes were broadly comparable to placebo, although peripheral edema occurred more frequently.

RevDate: 2026-08-25

Kim MH, Colantonio LD, Glymour MM, et al (2026)

Discordance Between Cognitive Impairment Status and Claims-Based ADRD Diagnosis: Temporal Patterns and Racial Differences in the REGARDS Cohort, 2006 to 2021.

Alzheimer disease and associated disorders [Epub ahead of print].

INTRODUCTION: Understanding the concordance between incident cognitive impairment status and the diagnosis of Alzheimer disease and related dementias (ADRD) is clinically important, as a diagnosis serves as the gateway for treatment, care planning, and supportive services.

METHODS: Using the REGARDS cohort (2006 to 2021) linked to Medicare claims, we examined the discordance between incident cognitive impairment and claims-based ADRD diagnoses. Directly standardized diagnosis rates were estimated by year, overall, and race, and stratified by cognitive impairment status. Logistic regression models were used to examine sociodemographic correlates of diagnosis.

RESULTS: The sample included 45,191 observations (23% Black) of 8368 participants. Among those with incident cognitive impairment, 30.8% received a claim-based diagnosis, and while 8.9% of those without incident cognitive impairment received a claim-based diagnosis. ADRD diagnosis rates remained stable, whereas rates among observations with incident cognitive impairment rose through the early 2010s, then plateaued and declined. The black race and education below the college level were associated with lower odds of diagnosis in this group; female sex was associated with higher odds. Among observations without cognitive impairment, older age and female sex were associated with higher odds; Midwest or West/Northeast residence and less than high school education were associated with lower odds.

DISCUSSION: Differences observed in the study may potentially represent underlying disparities in access to care and dementia diagnosis in clinical practice.

RevDate: 2026-08-25

Gao W, Hu K, Yang G, et al (2026)

Puerarin alleviates memory deficits through the modulation of D‑serine-mediated N-methyl-D-aspartate receptor activity in presenilin 1/2 conditional double knockout mice.

Phytomedicine : international journal of phytotherapy and phytopharmacology, 161:158727 pii:S0944-7113(26)00958-X [Epub ahead of print].

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline, the formation of amyloid-β plaques and neurofibrillary tangles, and synaptic dysfunction. Puerarin (PUE), an isoflavone C-glycoside extracted from Pueraria lobata, has demonstrated potential in attenuating AD-related cognitive decline; however, the mechanisms governing the effects of PUE remain incompletely understood.

PURPOSE: To investigate the mechanisms underlying PUE's anti-AD effects.

METHODS: Presenilin 1/2 conditional double knockout mice served as the AD model. Following one month of PUE administration, memory function was evaluated through behavioral testing, and hippocampal synaptic plasticity was assessed using electrophysiological recordings. D‑serine levels were quantified via ELISA. Additionally, Western blotting and qRT-PCR were employed to analyze the expression of glutamate receptor subunits and key enzymes involved in D‑serine metabolism. The mechanistic role of D‑serine was further validated through intrahippocampal D‑serine injections in mice and the application of a serine racemase (SR) inhibitor in N2a cells.

RESULTS: PUE administration reversed memory impairment and enhanced both hippocampal long-term potentiation and synaptic transmission by increasing the open probability of N-methyl-D-aspartate receptor (NMDAR) channels. Furthermore, PUE elevated D‑serine levels and upregulated the expression of SR. Notably, these therapeutic effects were replicated by exogenous D‑serine and abolished by treatment with an SR inhibitor.

CONCLUSION: These findings indicate that PUE alleviates cognitive deficits by promoting SR-mediated D‑serine biosynthesis and subsequently restoring NMDAR activity. Accordingly, PUE represents a viable therapeutic candidate for the prevention and management of AD.

RevDate: 2026-08-23
CmpDate: 2026-08-23

Fujita S, Fushimi Y, Otsuka Y, et al (2026)

Brain Amyloid Burden Mapping Using MR Fingerprinting Aided by Deep Learning.

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 25(4):.

PURPOSE: To develop and externally validate a non-invasive framework for quantifying brain amyloid-β (Aβ) deposition using magnetic resonance fingerprinting (MRF) and neural network-based decoding, with positron emission tomography (PET) as the reference standard.

METHODS: This prospective multi-site study included 44 participants from 2 sites who had undergone, or were scheduled to undergo, Aβ PET within 1 year. MRF was performed on a 3T MR system using a 2D fast imaging with steady-state precession sequence with B1 correction, covering the whole brain in 9.5 min. PET images were co-registered to the MRF space, and regional amyloid load was calculated using an automated template-based pipeline. An inverse mapping function was implemented to convert MRF signals into amyloid burden maps. Repeatability, agreement with PET-based centiloid values, and associations with cognitive scores were evaluated.

RESULTS: The generated amyloid maps were visually similar to PET images. Test-retest analysis showed high repeatability, with a coefficient of variation of 1.8 ± 1.3% and an intraclass correlation coefficient of 0.84. In the external test set, MRF-based measurements correlated significantly with PET centiloid scores (Spearman's ρ = 0.589, P = 0.015) and Montreal Cognitive Assessment scores (ρ = -0.543, P = 0.020).

CONCLUSION: The proposed framework enables non-invasive Aβ mapping using a clinically feasible MRI protocol and may support repeated assessment for monitoring during anti-amyloid treatment.

RevDate: 2026-08-24

Khan MS, Ashesh AM, Mammen MV, et al (2026)

Targeting NMDA Receptor Pathways in Alzheimer's Disease, From Cellular Mechanisms to Treatment Strategies.

Current neuropharmacology pii:CN-EPUB-157810 [Epub ahead of print].

The Alzheimer's Disease (AD) lacks effective disease-modifying therapy, even though amyloid-targeting immunotherapies have recently been applied clinically. N-methyl-D-Aspartate Receptors (NMDARs) play a central yet mechanistically complicated role in the pathophysiology of AD, where they are convergence points of amyloid-beta (Aβ) oligomer toxicity, tau-dependent excitotoxicity, and progressive synaptic failure. This critical review examines NMDAR dysfunction across the AD spectrum, with a focus on subunit-regulated signalling, subcellular localisation, and subsequent pathological cascades. The effects of Aβ oligomers on NMDAR activity involve multiple mechanisms that disrupt their function, including glutamate dysregulation mediated by GLT-1, redistribution of GluN2B to extrasynaptic areas, and inhibition of JAK2-CREB via activation of extrasynaptic receptors. Tau enhances excitotoxic injury throughdendritic mislocalization, and the tau-Fyn-GluN2B complex, which propels pro-death signalling by DAPK1. This conceptually important prevailing synaptic-extrasynaptic dichotomy is fiercely criticised here, given evidence that synaptic receptors containing GluN2A also mediate pathological signalling during sustained Aß exposure, and that tri-heteromeric receptor populations are problematic for subunit-selective targeting. Neuroinflammation, dysfunction of the blood-brain barrier, and excitotoxic amplification via GluN2C/D-enriched receptor pools in neurons, astrocytes, microglia, oligodendrocytes, and endothelial cells are underexplored therapeutic targets for neurodegenerative disease (non-neuronal NMDARs). Memantine is the only approved NMDAR-targeting agent for AD. Subunit-selective antagonists have not been translated into clinical use, and the positive allosteric modulator dalzanemdor (SAGE-718) did not pass its randomised Phase 2 trial in 2024. The most mechanistically justified approach is to advance subunit-selective, compartment-specific, or protein-complexdisrupting strategies. Although it is not established whether any single NMDAR-targeting intervention will suffice as a disease-modifying therapy, the convergence of molecular, genetic, and clinical evidence positions NMDAR dysfunction as a tractable , if therapeutically demanding , node in the AD pathogenic network, warranting continued, mechanism-informed drug discovery.

RevDate: 2026-08-24

Cui H, Li Q, Yao Y, et al (2026)

Physicochemical Characterization and Biological Activity of Ethanol- Extracted Residue of Saussurea involucrata.

Combinatorial chemistry & high throughput screening pii:CCHTS-EPUB-157782 [Epub ahead of print].

INTRODUCTION: Saussurea involucrata's ethanol-extracted residue (ROSI), a byproduct of its oral liquid preparation, nevertheless holds significant therapeutic promise. To evaluate its potential as a treatment for neurodegenerative illnesses, this study investigates its physicochemical properties and biological activity.

MATERIALS AND METHODS: UV-Vis, IR spectroscopy, UHPLC-Q Exactive HFX systems, microscopy, powder characterisation, and thermogravimetric analysis were used to examine the physical and chemical characteristics of ROSI. Antioxidant activities and pancreatic lipase inhibition were assessed. Its therapeutic targets for neurodegenerative disorders were predicted by network pharmacology and molecular docking analyses.

RESULTS: ROSI demonstrated high organic acid content, a uniform porous structure, consistent particle size, and high thermal stability, meeting industrial flowability standards. While showing modest pancreatic lipase inhibition, it exhibited potent antioxidant activity. Pharmacomics analysis suggests ROSI may target multiple pathways involved in neurodegenerative diseases.

DISCUSSION: Despite its modest pancreatic lipase inhibitory effect, ROSI exhibits potent antioxidant activity and stable physicochemical properties suitable for industrial applications. Network pharmacology and molecular docking analyses reveal therapeutic potential for ROSI in neurodegenerative diseases such as Alzheimer's and Parkinson's. Consequently, ROSI serves as a natural antioxidant and a raw material for the development of functional foods and pharmaceuticals.

CONCLUSION: ROSI holds promise as an adjunctive treatment for neurodegenerative diseases, particularly for its antioxidant effects and industrial applicability. Further research should optimize its use in chronic disease management and explore its broader medicinal potential.

RevDate: 2026-08-24

Patnaik S, Patra PK, Patra CN, et al (2026)

Biomarkers, Diagnostics, and Emerging Therapies in Alzheimer's Disease: A Comprehensive Systematic Review (2015-2025).

Central nervous system agents in medicinal chemistry pii:CNSAMC-EPUB-157725 [Epub ahead of print].

INTRODUCTION: The underlying association between multiple risk factors like age, preexisting diseases, infections, traumatic brain injuries, and certain genetic factors makes the diagnosis and treatment a challenge in AD. Identification of biomarkers and proper diagnosis of AD could make its management easier. Advances in diagnostic techniques like Positron Emission Tomography (PET) imaging have greatly improved the ability to identify, detect early, monitor disease progression, and manage its therapy.

METHODS: The recent therapeutic advancements in treatments encompass immunotherapies aimed at amyloid-beta (Aβ) and tau proteins, novel drug delivery systems, non-pharmacological methodologies, and personalised medicine techniques, combination therapies, and non-invasive brain stimulation are important in the management of AD. Cholinesterase inhibitors, such as galantamine, rivastigmine, and donepezil, are used to enhance cognitive performance and reduce confusion. Moderate to severe AD, memantine, a N-methyl-D-aspartate receptor (NMDA) receptor antagonist, is prescribed. Researchers are looking into both active and passive vaccines to get antibodies to Aβ plaques, and monoclonal antibodies, such as Lecanemab and Donanemab, which are used to treat early-stage AD.

RESULTS: Ongoing research is focused on identifying new biomarkers and therapeutic targets, advancing gene therapy, and refining immunotherapeutic approaches for AD.

DISCUSSION: There is growing interest in comprehending the influence of lifestyle and environmental factors on the mitigation of AD risk. Ongoing research is essential to elucidate the complexity of AD pathophysiology and to create effective therapies.

CONCLUSION: This review highlights the critical need for future AD research to bridge identified gaps in early detection, focus on improving early diagnosis, developing more effective treatments, refining existing drugs and therapies, and understanding the underlying disease progression mechanisms.

RevDate: 2026-08-24

Tong Y, Hu G, Liu L, et al (2026)

Dynamic Entropic Mapping of Alzheimer's Neuropathology: Eyes-Open and Eyes-Closed EEG Biomarkers through Wavelet Entropy Analysis.

Current Alzheimer research pii:CAR-EPUB-157745 [Epub ahead of print].

BACKGROUND: Alzheimer's Disease (AD) is characterized by amyloid-β plaques and tau tangles, while current diagnostic tools are often invasive and costly. Electroencephalography (EEG) offers a non-invasive alternative, with alpha rhythm abnormalities as key features. Impaired alpha reactivity during the transition from Eyes-Closed (EC) to Eyes-Open (EO) reflects early thalamocortical dysfunction.

OBJECTIVE: This study employs EO/EC wavelet entropy analysis to assess neurodynamic features across frequency bands, aiming to explore entropy-based EEG markers for early AD detection.

METHODS: This cross-sectional study enrolled 60 participants (30 AD and 30 controls). EEG was recorded during 60-second EC and Eyes-Open (EO) states using a 20-channel system. Continuous Wavelet Transform (CWT) and multiscale entropy were used to assess complexity differences across bands and regions between groups.

RESULTS: AD patients showed reduced alpha entropy differences between EC and EO states. Multiscale entropy difference (ΔEN α) analysis revealed weaker modulation in β-α and θ-δ bands compared with HC. Occipital ΔEN α correlated significantly with MMSE, with the strongest association in the alpha band (r = 0.9000, P < 0.001).

DISCUSSION: This study applies dual-state wavelet entropy analysis to reveal impaired neural reactivity in AD during eyes-open and eyes-closed transitions. The ΔEN α metric distinguishes AD from controls and correlates with cognitive decline, reflecting reduced neural flexibility and disrupted frequency-specific network dynamics.

CONCLUSION: This study shows that dual-state wavelet entropy analysis, especially ΔEN α, is a noninvasive tool for detecting neurodynamic abnormalities in AD. It reflects loss of state-dependent responsiveness and neural complexity, with potential for early screening and objective evaluation of treatment.

RevDate: 2026-08-24

Mishra R, Chauhan N, KK Agrawal (2026)

Current Targeted Nanoparticle Therapy for Alzheimer's Disease: Current Advances and Future Prospects.

Current neurovascular research pii:CNR-EPUB-157581 [Epub ahead of print].

BACKGROUND: The effects of Alzheimer's disease (AD) on society are profound. The blood-brain barrier selectively permits the penetration of specific forms of molecules through the blood circulation into the CNS, which can restrict the effectiveness of medications supplied systemically. The therapeutic targets are located in the CNS. However, local administration channels to the CNS are rather intrusive, which can lead to patient discomfort and limit the feasibility of repeated treatments.

METHODOLOGY: This article has evaluated treatment methodologies for AD that use nanoparticles to target the brain and the pathological features of the illness. The material that is currently available has been categorized based on the aspect of AD that is discussed: targeted medication and neurodegeneration.

RESULT: The use of nanoparticles in the targeted delivery of medications intended to alleviate the symptoms of AD or halt the disease's progression has yielded positive results. Because of their multivalence, nanoparticles can target the treatment site, pass through the blood-brain barrier, and be functionalized with various targeting groups. Intravenous administration, rather than more intrusive techniques, has enhanced drug bioavailability in the CNS. Furthermore, the development of vaccinations and medication formulations for intranasal delivery has utilized nanoparticles.

DISCUSSION: This study focused on the advancement of AD treatment. Nanoparticles are designed to enhance drug bioavailability through intravenous and intranasal routes for quicker brain access with fewer side effects. Nanoparticles also aid in targeting disease features like amyloid- beta plaques and tau tangles. While results in animal models are positive, transitioning to human clinical trials requires a more profound understanding of AD mechanisms and biomarker identification.

CONCLUSION: Research employing animal models suggests that targeted nanoparticles can enhance the effectiveness of AD treatments. A deeper understanding of AD mechanisms will lead to more successful targeted nanoparticle applications.

RevDate: 2026-08-24

Du Y, Li J, Han F, et al (2026)

Safety Comparison of Acetylcholinesterase Inhibitors Using FAERS Spontaneous-Reporting Data: Drug-Specific Reporting Signals and Time-to-Onset Dynamics.

Current Alzheimer research pii:CAR-EPUB-157639 [Epub ahead of print].

INTRODUCTION/OBJECTIVE: Acetylcholinesterase Inhibitors (AChEIs) are widely used for symptomatic treatment of Alzheimer's disease, but their post-marketing reporting profiles may differ. This study compared FAERS disproportional reporting signals and Time-To-Onset (TTO) patterns for donepezil, galantamine, and rivastigmine.

METHODS: FAERS reports from Q1 2004 to Q2 2025 were analyzed. Reports listing donepezil, galantamine, or rivastigmine as the primary suspect drug were retained. Unique case-drug-Preferred Term (PT) triplets were constructed after case-level and drug-event-level de-duplication. Positive signals were defined conservatively by the intersection of ROR, PRR, BCPNN, and MGPS/EBGM criteria. TTO was evaluated using cumulative onset-distribution curves, Weibull models, and Accelerated Failure-Time (AFT) models.

RESULTS: The analysis included 9,474 donepezil reports, 3,042 galantamine reports, and 14,666 rivastigmine reports. The four-method intersection identified 286 positive PT reporting signals for donepezil, 143 for galantamine, and 259 for rivastigmine. Donepezil showed prominent cardiac reporting signals, including sinus bradycardia (ROR = 49.0) and electrocardiogram QT prolongation (ROR = 16.75). Rivastigmine showed application-site signals, including application-site erythema (ROR = 21.36) and application-site pruritus (ROR = 18.07). Galantamine showed signals including bradycardia (ROR = 15.37), fall (ROR = 3.44), and decreased appetite (ROR = 3.57). Median TTOs were 38, 44, and 64 days for donepezil, galantamine, and rivastigmine, respectively. Rivastigmine showed a later reported onset than donepezil in the AFT model (TR = 1.08; p = 0.008).

DISCUSSION: The findings suggest shared cholinergic reporting patterns and drug-specific signal profiles. Because FAERS lacks exposure denominators, these results indicate disproportional reporting rather than incidence, causality, or comparative clinical risk.

CONCLUSION: Donepezil, galantamine, and rivastigmine showed distinct FAERS reporting profiles and early post-initiation TTO patterns. These findings are hypothesis-generating and require confirmation in independent pharmacovigilance or clinical datasets.

RevDate: 2026-08-25
CmpDate: 2026-08-24

Kordi MR, Kooshan AR, Jafari-Hokmabadi SP, et al (2025)

Combating cognitive decline in a rat model of Alzheimer's disease: The role of high-intensity interval training and cannabidiol administration in modulating microRNA-124, BACE1, and nestin.

Current journal of neurology, 24(3):219-228.

Background: The global prevalence of Alzheimer's disease (AD) has emerged as a paramount concern due to the aging population. The current research examines the effects of six-week high-intensity interval training (HIIT), with and without cannabidiol (CBD) supplementation, on cognitive decline, micro ribonucleic acid (miRNA)-124 expression levels, and the protein expression of beta-site amyloid precursor protein cleaving enzyme 1 (BACE1) and nestin in the hippocampus of rats with amyloid beta (Aβ)-induced AD. Methods: 30 male Wistar rats were randomly divided into six groups: control (CNT), sham, Alzheimer (AD), Alzheimer + HIIT (H-AD), Alzheimer + CBD (C-AD), and Alzheimer + HIIT + CBD (CH-AD). Following the hippocampal injection of Aβ1-42, the HIIT protocol and CBD supplementation [20 mg/kg/day, per os (P.O.)] were initiated and conducted over six weeks. After the last intervention, the hippocampus tissues were collected to assess miRNA-124 expression levels and the protein expression of BACE1 and nestin. Results: HIIT alone and in combination with CBD treatment significantly improved cognitive impairment induced by AD. Moreover, both treatments significantly reduced BACE1 protein expression and increased nestin protein expression in AD rats. However, despite decreased miRNA-124 expression levels in the AD group in comparison with the CNT group, HIIT and CBD administration did not alter miRNA-124 expression levels in other groups. Conclusion: The findings can contribute to a higher understanding of the beneficial effects of HIIT combined with CBD administration in mitigating AD-induced cognitive impairment by reducing BACE1 protein expression and increasing nestin protein expression.

RevDate: 2026-08-21

Chang Y, Kim HJ, Kim Y, et al (2026)

Exogenous lactate ameliorates Aβ-induced energy deficit and neurotoxicity with increased mitochondrial TCA cycle carbon flux in SH-SY5Y cells.

American journal of physiology. Cell physiology [Epub ahead of print].

A growing body of evidence has demonstrated the existence of metabolic dysfunction in neurodegenerative diseases, including Alzheimer's disease (AD), suggesting that deprivation of energy substrates impairs cellular dynamics. As the glucose utilization declines in AD patients, the need for alternative energy sources becomes crucial to sustain neuronal activities and prevent cell death induced by neurotoxic proteins, such as amyloid beta (A(?)) aggregates. In this context, lactate has been investigated as a potential alternative brain energy substrate in several studies, yet its impact on neuronal cells under A(?)-induced toxicity remains unclear. We confirmed significant suppression of energy production-related biological pathways by analyzing brain transcriptomic data of AD patients. In subsequent in vitro studies, exogenous lactate treatment ameliorated neuron-like cell death caused by A(?) aggregates. Using a [13]C stable isotope tracer, we verified cellular lactate uptake and its incorporation into TCA cycle in neurons under the neurotoxic condition. [13]C metabolic flux analysis further supported these findings by revealing that lactate treatment restored Aβ-suppressed mitochondrial TCA cycle fluxes. These metabolic improvements were accompanied by increased expression of mitochondrial proteins. These findings support lactate shuttling as a mechanism for supplying lactate-derived carbon to mitochondrial energy metabolism, which may improve neuronal resilience under Aβ-induced metabolic stress.

RevDate: 2026-08-21

Quan YS, Liu JY, Liu H, et al (2026)

Design synthesis and evaluation of usnic acid derivatives as multi-target drugs for Alzheimer's disease.

Bioorganic chemistry, 181:110398 pii:S0045-2068(26)00934-X [Epub ahead of print].

The pathogenesis of AD is complex, and existing clinical drugs only alleviate symptoms and are difficult to block the course of the disease. Although UA has neuroprotective activities such as antioxidant and anti-inflammatory properties, its anti-AD activity is severely restricted by drug defects such as a single target and insufficient blood-brain barrier permeability. Therefore, this study takes UA as the lead compound, designs and synthesizes 38 UA derivatives, systematically evaluates their anti-AD biological activity, and aims to screen for multifunctional anti AD lead compounds. Among them, the lead compound S12 exhibited exceptional activity, with an EC50 value of 1.24 μM representing a 17.9-fold improvement in potency relative to the parent compound. Furthermore, WB assays were conducted to elucidate the underlying mechanism of action of this compound. The results revealed that compound S12 exerts anti-AD activity through the synergistic modulation of multiple signaling pathways: it inhibits activation of the MAPK and NF-κB pathways, as well as aberrant phosphorylation of tau protein; concurrently, it downregulates BACE1 expression to reduce Aβ production, and suppresses activation of the Bax/Bcl-2 pathway thereby inhibiting caspase-1 activation and ultimately confers neuroprotective, anti-AD effects. The apparent permeability coefficient of compound S12 across an in vitro (BBB) model was determined to be 7.66 × 10[-6] cm/s, confirming its ability to effectively cross the BBB. Further pharmacological evaluation demonstrated that S12 exerted a potent ameliorative effect on learning and memory deficits in an AD mouse model. In vivo toxicity assessment, no gross or histopathological abnormalities were observed in the major organs, including the heart, liver, spleen, and kidneys. Moreover, S12 significantly attenuated neuronal pathological injury in the hippocampus of Aβ-induced AD model mice, underscoring its robust neuroprotective activity. In conclusion, compound S12 demonstrates robust efficacy in ameliorating learning and memory deficits, enhancing blood-brain barrier permeability, and exerting anti-AD activity. Accordingly, it represents a highly promising multifunctional therapeutic candidate for the treatment of AD.

RevDate: 2026-08-22

Alsharayri S, Knox S, Cutty M, et al (2026)

Dual eligibility and neuropsychiatric symptoms and treatment disparities among Medicare Part D beneficiaries with Alzheimer's disease and related dementias.

Journal of Alzheimer's disease : JAD [Epub ahead of print].

BackgroundNeuropsychiatric symptoms (NPS) are common and clinically consequential in Alzheimer's disease and related dementias (ADRD), yet their recognition and treatment may vary across socioeconomic groups. Dual-eligible Medicare-Medicaid beneficiaries represent a vulnerable population, but differences in NPS documentation and management remain unclear.ObjectiveTo examine whether dual eligibility is associated with differences in (1) documented NPS and (2) prescription fills among Medicare beneficiaries with ADRD who received home health (HH) care.MethodsWe conducted a cross-sectional study of 167,484 Medicare Part D beneficiaries with ADRD who received HH care and were identified using the Chronic Conditions Warehouse flag. Dual eligibility was the primary exposure. NPS were identified using diagnosis codes from medical claims. Prescription fills for NPS-related medications were identified using Medicare Part D prescription drug event data (≥2 prescription fills for anxiety-related medications and antidepressants). Logistic regression models estimated associations of dual eligibility with NPS documentation and prescription fills, adjusting for demographic characteristics, original Medicare entitlement, and comorbidity burden.ResultsDual-eligible beneficiaries comprised 30.7% of the cohort. Documented confusion and anxiety were the most prevalent symptoms. Dual-eligible beneficiaries had a higher prevalence of confusion (83.5% versus 82.0%) and anxiety (57.0% versus 53.2%) compared with Medicare-only beneficiaries. After adjustment, dual eligibility was associated with higher odds of documented confusion (aOR 1.18, 95% CI 1.14-1.22) and anxiety (aOR 1.19, 95% CI 1.15-1.22). Dual eligibility was also associated with slightly higher odds of anxiety-related prescription fills (aOR 1.21, 95% CI 1.17-1.26), whereas antidepressant prescription fills did not differ (aOR 1.00, 95% CI 0.95-1.05).ConclusionsDual eligibility was associated with modest differences in NPS documentation and prescription fills, suggesting differences in recognition and management of NPS among beneficiaries with ADRD.

RevDate: 2026-08-24
CmpDate: 2026-08-22

Shafi S, GA Ansari (2026)

Developing artificial intelligence-based techniques for brain MRI image segmentation.

Frontiers in neuroscience, 20:1894751.

INTRODUCTION: Brain MRI image segmentation is essential for the accurate diagnosis and treatment of neurological disorders, including brain tumors, Alzheimer's disease, and multiple sclerosis. Artificial intelligence (AI), particularly deep learning, has emerged as an effective approach for improving the precision and efficiency of medical image segmentation while reducing manual effort.

METHODS: This study utilized a publicly available Kaggle brain MRI dataset containing labeled images for supervised learning. A Convolutional Neural Network (CNN)-based framework was developed for automatic brain MRI segmentation. The methodology incorporated preprocessing techniques, including noise removal, normalization, and data augmentation, to improve image quality and model performance. The proposed model was evaluated using Accuracy, Dice Score, and Intersection over Union (IoU).

RESULTS: Experimental results demonstrated that the proposed AI-based segmentation framework achieved high segmentation accuracy and effectively distinguished normal brain tissue from abnormal regions. The model outperformed conventional image-processing methods by providing improved segmentation precision, reducing manual intervention, and enhancing the reliability of medical image analysis.

DISCUSSION: The findings demonstrate the potential of AI-based deep learning techniques for automated brain MRI segmentation in clinical applications. The proposed framework can support clinicians by improving diagnostic accuracy and reducing processing time. Future work will focus on implementing more advanced deep learning architectures and expanding the dataset to further improve segmentation performance and clinical applicability.

RevDate: 2026-08-24
CmpDate: 2026-08-22

Chen X, Boey J, Wei K, et al (2026)

The Use of Dynamic Neck Lymphaticovenous Anastomosis in the Adjunctive Treatment of Alzheimer's Disease: A Retrospective Case Series.

Archives of plastic surgery, 53(4):352-360.

BACKGROUND: Lymphovenous anastomosis (LVA) has recently emerged as a potential method for the symptomatic management of Alzheimer's disease (AD). Building on this, we conceptualize the "dynamic neck lymphovenous anastomosis" (DN-LVA) to illustrate the versatility of our technique. DN-LVA utilizes a vein graft that traverses through the sternocleidomastoid muscle to facilitate the drainage of lymphatic fluid from the deep cervical lymphatic vessels to the external jugular vein.

METHODS: This study presents a retrospective analysis of patients who underwent DN-LVA between November 2024 and January 2025. The clinical outcome was evaluated through positron emission tomography/computed tomography (PET/CT) imaging and cognitive assessment tools, which included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR). The vein graft was harvested from the lower limb.

RESULTS: Five subjects were recruited into this study. Postoperative PET/CT scans revealed up to a 6.9% increase in glucose metabolism in patient 3, a decrease of 12.3% in amyloid deposits, and a 4.7% reduction in tau deposits in patient 5 and patient 4, respectively. Clinically, MMSE and MoCA scores were improved by 1.8 and 1.4, respectively. NPI scores decreased by 5.8 across five overall, and the CDR remained unchanged in all subjects. All grafts demonstrated vessel patency, and no postoperative complications were observed.

CONCLUSION: DN-LVA appears to be a safe, minimally invasive procedure with potential cognitive and metabolic benefits in AD. Further studies with larger cohorts and longer follow-up are warranted to confirm these preliminary findings.

RevDate: 2026-08-24
CmpDate: 2026-08-22

de Oliveira GLDS, AG Bertollo (2026)

Non-pharmacological strategies for the management of Alzheimer's disease.

Dementia & neuropsychologia, 20:e20250290.

Alzheimer's disease (AD) is a multifactorial neurodegenerative disease affecting various cognitive domains, requiring a holistic and integrated therapeutic approach. The treatment of AD goes beyond pharmacological interventions, also necessitating non-pharmacological therapies that can act synergistically, both with each other and with emerging pharmacological treatments, including new anti-amyloid therapies. These therapies aim to improve patients' quality of life and alleviate behavioral symptoms, such as agitation and depression, and delay disease progression. Current clinical and meta-analytic evidence suggests that these approaches can be effectively integrated with conventional treatment, offering a valuable alternative to enhance patients' overall well-being. However, further research is needed to deepen the understanding of the ideal combination of the new anti-amyloid therapies, to address the limitations of current evidence, and to robustly establish their effectiveness in the clinical context of AD, aiming to generate a broader and more lasting impact on disease treatment. This narrative review aims to synthesize the evidence on diverse non-pharmacological therapies for managing AD and discuss their practical implications for clinical care.

RevDate: 2026-08-22
CmpDate: 2026-08-22

Elwakil BH, Helal AM, El-Khatib M, et al (2026)

Multilayered Silica-Core/Chitosan-Coated Nanostructures Co-Delivering Tamoxifen and Quercetin Mitigate LPS-Associated Neurodegenerative and Alzheimer's Disease-Like Alterations.

Journal of biomedical materials research. Part B, Applied biomaterials, 114(8):e70150.

Cholinergic dysfunction, oxidative stress, neuroinflammation, and proteinopathies are among the major hallmarks of Alzheimer's disease (AD). This study aimed to develop and evaluate the therapeutic potential of multilayered silica-based/chitosan-coated nanoparticles (Si@CsNPs) co-loaded with quercetin (QUR) and tamoxifen (TAM) in an LPS-induced neuroinflammatory murine model exhibiting AD-like neuropathological alterations associated with bacterial endotoxin exposure. Molecular docking and target prediction analyses suggested that TAM may exert partial cholinesterase inhibitory activity and potentially interact with muscarinic receptor- and epidermal growth factor receptor (EGFR)-associated pathways, which are implicated in neuroinflammation and oxidative stress regulation. The resulting silica-based/chitosan-coated nanoparticles (Si@CsNPs) co-loaded with QUR and TAM (QUR/TAM-Si@CsNPs) were spherical in shape, exhibited a core-shell architecture, and demonstrated high loading efficiencies for QUR (93.1% ± 2.56) and TAM (84.27 ± 3.66), with a mean particle diameter of approximately 135 nm as determined by TEM. Behavioral assessment using Morris Water Maze revealed that lipopolysaccharide (LPS) administration impaired spatial learning and memory in rats; these effects were significantly ameliorated by QUR/TAM-Si@CsNPs treatment, to a greater extent than Si@CsNPs loaded individually with QUR or TAM. Biochemical, apoptotic, and histopathological analyses further demonstrated that treatment with QUR/TAM-Si@CsNPs normalized acetylcholinesterase activity, Tau protein level, β-amyloid accumulation, pro-inflammatory mediators, and apoptotic indices while preserving hippocampal architecture. Collectively, these findings demonstrate that QUR/TAM-Si@CsNPs exert combined anti-inflammatory and neuroprotective effects, highlighting their promise as a multifunctional nanotherapeutic strategy against LPS-associated neurodegenerative and AD-like neuropathological alterations.

RevDate: 2026-08-22

Gopal RK, Pathoor NN, PS Ganesh (2026)

Eubiosis and dysbiosis in periodontitis-related systemic diseases.

Journal of periodontology [Epub ahead of print].

BACKGROUND: This narrative review examines the eubiosis-dysbiosis spectrum in periodontitis and its systemic implications. Evidence is drawn from the literature through 2026; as a narrative review, some selection bias cannot be excluded. Periodontitis, affecting 10%-15% of adults globally, drives systemic health disorders through microbial dysbiosis.

OBJECTIVES: This narrative review examines microbial ecological shifts in periodontitis and their implications for cardiovascular disease (CVD), diabetes mellitus (T2D), neurodegenerative disorders, rheumatoid arthritis (RA), and other systemic conditions.

METHODS: We have synthesized the current evidence on oral microbiome transitions from eubiosis to dysbiosis, focusing on mechanistic pathways linking periodontal disease to systemic health outcomes.

RESULTS: Periodontal dysbiosis may influence systemic health through mechanisms including bacteremia, chronic inflammation, molecular mimicry, and microbiome axis interactions. Individuals with periodontitis show 1.5 to 2-fold increased cardiovascular risk, bidirectional relationships with diabetes (HbA1c reductions of 0.3%-0.5% following periodontal treatment), and associations with Alzheimer's disease, rheumatoid arthritis, and inflammatory bowel disease. Key pathogens including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum have been proposed as keystone species capable of remodeling microbial communities and potentially contributing to systemic effects.

CONCLUSIONS: Understanding the eubiosis-dysbiosis spectrum provides crucial insights into oral-systemic health connections and offers therapeutic targets for managing both periodontal and systemic diseases. Integrated medical-dental care approaches, precision medicine strategies, and microbiome-based therapeutics represent promising future directions.

RevDate: 2026-08-22

Dineshbhai TK, Rafaliya D, Singh A, et al (2026)

Emerging diagnostic biomarkers and therapeutic targets in Alzheimer's disease.

Inflammopharmacology [Epub ahead of print].

Alzheimer's disease (AD) is a progressive neurodegenerative disease and is the most common cause of dementia in the world. Cognitive decline, memory problems, behavioral disturbances, and, finally, loss of functional independence characterize it. AD has risen and continues to increase globally, especially among aging people. A team of researchers at the University of Alberta says that we need faster, better diagnosis and treatment of AD. It elaborates on the progressive understanding of AD pathophysiology, biomarkers, emergent targets, and the latest delivery solution. The paper covers and discusses various disease-causing mechanisms like plaque formation, tau hyperphosphorylation, etc., which causes AD. Research is also being undertaken on the role of genetic and epigenetic factors in the pathogenesis and evolution of diseases, including but not limited to APOE polymorphisms, DNA methylation, modifications of histones, and non-coding RNAs. Researchers have discovered biomarkers relevant to AD, particularly those found in CSF and blood. The biomarkers include Aβ42, phosphorylated tau, neurofilament light chain, GFAP, and TREM2. Other biomarkers include salivary, urinary, neuroimaging, and digital. Next come the therapeutic strategies targeting amyloid aggregation, tau pathology, and other types of dysfunctions. Recent developments in monoclonal antibodies, kinase inhibitors, anti-inflammatory agents, neurotrophic agents, and antioxidant therapies are stressed. Moreover, nanotechnology-based and targeted delivery systems being developed for drugs include, but are not limited to, liposomes, polymeric nanoparticles, dendrimers, nanoemulsions, and intranasal formulations to enhance blood-brain barrier permeability. A combination of biomarker-guided diagnostics with mechanism-based therapies might enable precision medicine approaches and improve clinical outcomes in AD.

RevDate: 2026-08-22

Chenxi D, Miaomiao W, Jiahui F, et al (2026)

Technological evolution of hyperthermia: From traditional moxibustion to nanomaterial-mediated platforms for inflammatory diseases.

Journal of thermal biology, 140:104557 pii:S0306-4565(26)00190-7 [Epub ahead of print].

Hyperthermia, a physical therapeutic modality with unique advantages in treating inflammatory diseases, has evolved rapidly from empirical practice to precision medicine. Technologically, it has expanded from whole-body hyperthermia and traditional moxibustion to localized approaches, including photothermal, magnetothermal, ultrasound, and implantable platforms. Traditional moxibustion acts through heat and near-infrared radiation, while nanomaterials and smart devices now enable precise control over temperature, spatial targeting, and treatment duration. these modalities converge on conserved mechanisms: TRPV channel activation, HSF1-HSP70 induction, and immune modulation, which collectively alleviate inflammation and promote tissue repair in inflammatory bowel disease, osteoarthritis, and Alzheimer's disease. This review summarizes technological evolution, mechanistic insights and therapeutic applications, thereby providing a framework for developing precision hyperthermia strategies and multifunctional platforms for inflammatory diseases.

RevDate: 2026-08-24

Yi F, Ma J, Zhao R, et al (2026)

Zonisamide improves cognitive impairment and psychiatric symptoms related with SAPAP3 in mouse models of Alzheimer's disease.

European journal of pharmacology, 1033:179279 pii:S0014-2999(26)00761-2 [Epub ahead of print].

BACKGROUND: Alzheimer's disease (AD) is characterized by pathological changes in Aβ&Tau, cognitive impairment, and may also manifest psychiatric symptoms. Zonisamide (ZNS) has been demonstrated its improvement of cognitive dysfunction in T2DM mice in our previous study. However, the efficacy and mechanism of ZNS in treating AD remain unclear.

AIM: We aims to investigate the therapeutic efficacy of ZNS for AD and its potential molecular mechanisms.

METHODS: Three-month-old 5xFAD mice were treated with ZNS (20 mg/kg, i.p.) for 12-week. The behavioral test assesses cognitive function and psychiatric symptoms. Aβ-PET/CT, immunofluorescence, and Thioflavine-S staining assessed the levels of Aβ plaques. Proteomics and Western blot analyses evaluated synapse-associated proteins, amyloid precursor protein (APP) related proteins and phosphorylated tau.

RESULTS: We discovered for the first time that ZNS significantly improved spatial learning and memory, and also alleviated psychiatric symptoms in 5xFAD. Besides, ZNS increased PSD95, SYP, BDNF, and SAP90/PSD-95-related protein 3 (SAPAP3), which plays a crucial role in compulsive-like behaviors. Importantly, siRNA-mediated knockdown of SAPAP3 in N2A/APP cells inhibited the regulatory effect of ZNS on PSD95 and NMDAR2A (NR2A). In addition, ZNS treatment reduced Aβ deposition in the brain. It also downregulated APP, p-APP (Thr668), BACE1, and PS1, and attenuated tau phosphorylation at Ser396 by inhibiting its upstream kinase ERK1/2 activity.

CONCLUSION: ZNS exerts neuroprotective effects in 5xFAD mice and improves AD-related cognitive impairment and AD-like lesions, which establishes ZNS as a promising therapeutic avenue for AD and its associated psychiatric symptoms.

RevDate: 2026-08-24
CmpDate: 2026-08-23

Chen H, Si Y, Cheng Q, et al (2027)

Therapeutic potential and underlying mechanisms of engineered young plasma-derived exosomes in Alzheimer's disease.

Bioactive materials, 67:497-523.

Exosomes (EXOs) derived from the plasma of young individuals are believed to have the potential to ameliorate aging-related memory deficits. However, their specific roles and mechanisms in Alzheimer's disease (AD) therapy have not yet been systematically investigated. In this study, the rabies virus glycoprotein-targeting peptide (RVG-29) was conjugated to the surface of young plasma-derived EXOs to construct RVG-engineered EXOs (RVG-EXOs), and their therapeutic potential and underlying mechanisms in AD models were systematically evaluated. In 3×Tg AD model mice, exogenous administration of young plasma-derived EXOs and their engineered product (RVG-EXOs) revealed that RVG-EXOs could more efficiently enter brain tissue and target neurons, significantly reduce Aβ plaque and phosphorylated Tau (P-Tau) pathological deposition, restore synaptic structure, promote neuronal survival, and improve cognitive behavior. Mechanistic studies demonstrated that RVG-EXOs inhibited RPTOR expression, thereby activating the autophagy pathway and promoting the clearance of pathological proteins. Both in vitro and in vivo experiments confirmed that overexpression of RPTOR significantly suppressed the therapeutic effects of RVG-EXOs. single-cell transcriptomic profiling further revealed that RVG-EXOs not only increased neuronal proportion and modulated excitatory/inhibitory neuronal balance but also reshaped the microglial landscape by reducing deleterious disease-associated while increasing homeostatic surveillant microglia. In summary, this study not only reveals for the first time the potential value of young plasma-derived EXOs in AD treatment but also, through RVG engineering strategies and the elucidation of the RPTOR-autophagy mechanism, provides new insights for targeted therapy of neurodegenerative diseases.

RevDate: 2026-08-21
CmpDate: 2026-08-21

Wang Q, Wei Y, Shen C, et al (2026)

CT1812 Attenuates Surgery-Induced Cognitive Impairment and Modulates TMEM97- and PGRMC1-Associated Hippocampal Stress Responses in Aged Mice.

Neurochemical research, 51(5):.

Postoperative neurocognitive disorders (PND) are common complications in older surgical patients, but druggable mechanisms linking surgical trauma to hippocampal synaptic and cognitive vulnerability remain poorly defined. The σ-2 receptor (σ-2R), encoded by transmembrane protein 97 (TMEM97), and progesterone receptor membrane component 1 (PGRMC1) intersect membrane lipid biology and synaptic stress signaling; CT1812, a pharmacological σ-2R complex modulator, has shown target engagement in early Alzheimer's disease trials, but whether this pathway participates in postoperative hippocampal injury is unknown. This study examined whether surgery-induced hippocampal stress in aged mice is associated with TMEM97 and PGRMC1 signaling and whether early CT1812 treatment can attenuate this response. Young adult (2-3 months) and aged (18-20 months) male C57BL/6J mice underwent sham operation or laparotomy; aged mice were further treated with vehicle or CT1812 (3 mg/kg, intravenous injection, days 0-3). Hippocampal molecular changes were assessed by western blotting and immunofluorescence on day 3, and behavior was evaluated by open field test (OFT) and Morris water maze (MWM) on days 6-10. Laparotomy increased hippocampal TMEM97 and PGRMC1 expression and induced anxiety-like and spatial-memory deficits preferentially in aged mice, without evidence that locomotor impairment explained the behavioral phenotype. TMEM97 and PGRMC1 were detected in neuronal nuclei (NeuN)-positive neurons, ionized calcium-binding adapter molecule 1 (Iba-1)-positive microglia, and glial fibrillary acidic protein (GFAP)-positive astrocytes in hippocampal cornu ammonis 1 (CA1), supporting multicellular pathway involvement. In aged surgical mice, CT1812 significantly reduced upregulation of TMEM97 and PGRMC1, improved OFT center-zone occupancy and MWM performance, and restored the synaptic markers postsynaptic density protein 95 (PSD95) and synaptophysin. CT1812 also normalized lipid-handling proteins, including apolipoprotein E (ApoE), ATP-binding cassette transporter A1 (ABCA1), cholesterol 24-hydroxylase (CYP46A1), and low-density lipoprotein receptor (LDLR), and reduced perilipin 2 (PLIN2) accumulation in neurons and microglia. In parallel, CT1812 attenuated a selective endoplasmic reticulum (ER) stress response involving binding immunoglobulin protein (BIP) and protein kinase R-like endoplasmic reticulum kinase (PERK)-eukaryotic initiation factor 2α (eIF2α) signaling in hippocampal neurons, and suppressed microglial nuclear factor κB (NF-κB)/NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammatory activation, whereas C/EBP homologous protein (CHOP) was not significantly changed. These findings support a model in which postoperative injury in the aged hippocampus engages a lipid-proteostatic and inflammatory stress program associated with TMEM97 and PGRMC1, and suggest that CT1812 attenuates cognitive vulnerability by restraining this coupled response.

RevDate: 2026-08-23
CmpDate: 2026-08-21

Meiselbach MK, Xu J, Brown T, et al (2026)

Medicare Advantage Beneficiary Enrollment Decisions Following New Complex Conditions.

JAMA health forum, 7(8):e262843.

IMPORTANCE: Prior research has demonstrated higher rates of disenrollment from Medicare Advantage (MA) among people with greater health care needs. Yet, less is known about how disenrollment responds to changes in medical complexity, whether disenrollment varies by the degree of complexity, and how these patterns differ by state Medigap protections and MA plan characteristics.

OBJECTIVE: To examine changes in MA plan disenrollment following the development of new complex medical conditions and assess heterogeneity by number of conditions, state Medigap policy, and plan characteristics.

This cohort study used Medicare enrollment and claims data from 2016 to 2021. The study population included beneficiaries continuously enrolled in MA in 2016 without complex medical conditions from 2016 through 2018. A treatment group developed a new complex condition in 2019; a comparison group did not develop a complex condition through 2021. Data were analyzed from December 1, 2025, to March 1, 2026.

EXPOSURE: Development of 1 or more new complex medical conditions in 2019, including acute myocardial infarction, Alzheimer disease and related dementia, atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease, depression, congestive heart failure, or stroke.

MAIN OUTCOMES AND MEASURES: Annual disenrollment from the prior year MA plan, which included disenrollment to traditional Medicare (TM) or switching to another plan within MA. Difference-in-differences models with beneficiary and year fixed effects were estimated and converted to differences in percentage points.

RESULTS: The analytic sample included 1 054 926 beneficiaries, including 219 942 (mean [SD] age, 75.3 [6.3] years; 54.6% female) who developed new complex conditions in 2019 and 834 984 (mean [SD] age, 73.8 [5.6] years; 56.7% female) who did not develop a new complex condition in 2019. Developing any new complex condition was associated with an increase of 3.3 (95% CI, 3.1-3.5) percentage points (pp) in MA disenrollment, including an increase of 2.8 (95% CI, 2.7-2.9) pp in disenrollment to TM. The number of new complex conditions was associated with increased disenrollment, from 1.4 (95% CI, 1.3-1.6) pp for 1 condition to 12.8 (95% CI, 11.6-13.9) pp for 4 or more conditions. Disenrollment to TM was 1.5 (95% CI, 0.9-2.1) pp higher among beneficiaries residing in states with Medigap guaranteed issue and community rating protections.

CONCLUSIONS AND RELEVANCE: In this study, development of new complex medical conditions was associated with higher MA disenrollment, particularly to TM and in states with Medigap protections, and the magnitude increased with medical complexity. These findings highlight how changes in health status and state policy may shape Medicare coverage decisions.

RevDate: 2026-08-20

Zhang H, Lai J, Wang T, et al (2026)

Adaptation and feasibility of the International Registry for Alzheimer's Disease and Other Dementias real-world datasets in old-age mental healthcare practice in China.

Journal of Alzheimer's disease : JAD [Epub ahead of print].

BackgroundAnti-amyloid disease-modifying therapies (DMTs) for early Alzheimer's disease (AD) are entering routine care, increasing the need for harmonized, registry-ready real-world data. The International Registry for Alzheimer's Disease and Other Dementias (InRAD) proposed a minimum dataset (MDS) and extended dataset (EDS), but their applicability to psychiatry-led old age mental healthcare practices in China is uncertain.ObjectiveTo adapt the InRAD dataset for real-world AD DMT practice across multiple psychiatry institutions in China and assess the feasibility of routine data capture for the proposed MDS/EDS.MethodsWe conducted a modified Delphi consensus study and a multicenter feasibility survey. Forty-nine experts classified domains/items into the MDS or EDS using predefined agreement thresholds. Thirty-five DMT-initiating mental healthcare teams reported the routine availability of the proposed data elements.ResultsHighly consistent with InRAD, ten domains were included in the China-adapted MDS/EDS, covering patient profiles and lifestyle, diagnostic work-up and biomarkers, treatment, outcomes, safety, treatment-monitoring examinations, and registry discontinuation. However, item prioritization reflected local practice, emphasizing diagnostic traceability, functional and neuropsychiatric outcomes, caregiver burden, and structured safety capture. Feasibility results revealed that many MDS elements were collected, but the consensus-defined MDS exceeded what is currently captured in a standardized, analysis-ready format; most EDS items were moderately feasible, while WHO-5 (patient version) and DAT-scan were least feasible.ConclusionsAn InRAD-aligned dataset is broadly acceptable for psychiatry-led AD DMT practices in China, but implementation gaps remain. A phased registry approach with standardized definitions and workflow-supported capture may improve the completeness and comparability of real-world DMT evidence.

RevDate: 2026-08-21
CmpDate: 2026-08-20

Talebi A, Nabili S, Alaei M, et al (2026)

Exosome-derived biomarkers as non-invasive tools in stroke, Parkinson's disease, and Alzheimer's disease.

Metabolic brain disease, 41(1):.

Neurological disorders, including stroke, Parkinson's disease (PD), and Alzheimer's disease (AD), are among the most prevalent and debilitating neuropathological conditions, affecting over 50 million people globally. Effective prevention and treatment strategies require a comprehensive understanding of reliable and disease-specific biomarkers. Such insights can enhance diagnostic precision, enable early detection, and support the development of targeted therapeutic approaches. In this review, we focus on exosome-derived proteins and small non-coding RNAs as promising non-invasive biomarkers for stroke, PD, and AD, given the accessibility and stability of exosomes in biological fluids. Furthermore, we examine their potential diagnostic and therapeutic relevance, emphasizing their functional roles, specificity, and sensitivity. Finally, we discuss current limitations, emerging challenges, and future research directions to guide the advancement of exosome-based biomarker discovery and clinical translation in neurological disorders. However, we emphasize that the comparative effectiveness of exosomal microRNAs (miRNAs) versus protein biomarkers requires direct validation in future head‑to‑head cohort studies.

RevDate: 2026-08-20

Chen Y, Ge L, Lazarovici P, et al (2026)

Artemisinin Attenuates Aβ1-42 Aggregation via the CaMK IV/PKA-CREB-Ace-H4 Cascade in Neuronal Cultures and 3xTg-AD Models.

The American journal of Chinese medicine [Epub ahead of print].

Alzheimer's disease (AD), a progressive neurodegenerative disease with a rising global prevalence, is characterized by amyloid-β (Aβ) aggregation, tau hyperphosphorylation, inflammation, oxidative damage, and neuronal apoptosis. Studies have increasingly recognized epigenetic modifications as key regulators in the development of AD. Epigenetic modifications, particularly histone acetylation, are increasingly recognized as critical regulators of cell survival and AD pathogenesis. Although artemisinin (ART) exhibits potent anti-oxidative, anti-inflammatory, and neuroprotective properties, its impact on histone acetylation in AD remains uncharacterized. This study investigated whether ART regulates histone acetylation to confer neuroprotection and rescue behavioral deficits in Alzheimer's disease models. Using SH-SY5Y cells, primary neurons, and 3xTg-AD mice, we found that ART restores histone acetylation homeostasis by enhancing histone H4 acetylation. Mechanistically, this effect is driven by the activation of the CaMK IV/PKA-CREB signaling cascade. Treatment with ART reduced ROS, improved mitochondrial function, decreased Aβ1-42 deposition, and suppressed neuronal apoptosis. However, these beneficial effects were abolished by PKA or CaMK IV inhibitors. Consequently, ART treatment significantly reduced reactive oxygen species (ROS) generation, restored mitochondrial function, decreased Aβ1-42 deposition, suppressed neuronal apoptosis, and alleviated AD-like neuropathology and cognitive deficits. Crucially, the neuroprotective and epigenetic benefits of ART were entirely abolished by pharmacological inhibitors of PKA or CaMK IV. This study is the first to demonstrate that artemisinin ameliorates AD pathology and behavioral impairments via the CaMK IV/PKA-CREB-Ace-H4 axis, establishing ART as a promising therapeutic candidate for epigenetic intervention in AD.

RevDate: 2026-08-20

Wang X, Liu Y, Liu J, et al (2026)

Translational imaging evidence for rapid reversal of amyloid and myelin pathology following deep cervical lymphatic-venous anastomosis in Alzheimer's disease.

Nuclear medicine and biology, 160-161:109675 pii:S0969-8051(26)00074-0 [Epub ahead of print].

BACKGROUND: Recently, microsurgical restoration of extracranial lymphatic outflow through lymphatic-venous anastomosis (LVA) has been explored as a potential, albeit controversial, therapeutic strategy to enhance glymphatic clearance in Alzheimer's disease (AD); however, its impact on AD-related neuropathology has not yet been quantitatively or longitudinally evaluated. In this study, we performed translational PET imaging to determine whether restoring extracranial lymphatic outflow can rapidly and reversibly modulate cerebral glucose metabolism, myelin integrity, and amyloid burden in relation to cognitive improvement.

METHODS: A cervical lymphatic obstruction model was established in rats, followed by longitudinal [[18]F]FDG-PET and [[11]C]MeDAS-PET to assess cerebral glucose metabolism and myelin integrity before and after LVA, with imaging findings further validated by immunohistochemistry. A cohort of eight AD patients underwent LVA and received [[11]C]PIB and [[11]C]MeDAS PET imaging at baseline and follow-up. The imaging results were correlated with cognitive performance.

RESULTS: In Sprague-Dawley rats, cervical lymphatic obstruction led to significantly elevated cerebral glucose metabolism and reduced myelin integrity, both of which were largely restored to near-normal levels following LVA treatment, as further validated by immunohistochemical analyses. Similarly, in AD patients, LVA produced a 36.0 ± 2.1% decrease in cortical amyloid burden on [[11]C]PIB-PET (p < 0.001) and a 59.8 ± 29.0% increase in [[11]C]MeDAS uptake (p = 0.005). Subsequent correlation with MMSE scores demonstrated that short-term cognitive improvement was associated with greater myelin restoration and greater amyloid reduction.

CONCLUSION: These preliminary findings provide initial evidence that restoration of extracranial lymphatic outflow may modulate core neuropathological processes in AD, justifying further investigation in larger cohorts with appropriate control groups and randomized controlled designs to validate and extend these observations.

TRIAL REGISTRATION: The study was registered on the Chinese Clinical Trial website on April 21, 2025 (Registration No. ChiCTR2500101149).

RevDate: 2026-08-20

Yenkoyan K, Davtyan T, Torosyan H, et al (2026)

Bone marrow remodeling and brain-bone marrow crosstalk in Alzheimer's disease-like neurodegeneration.

Brain, behavior, and immunity pii:S0889-1591(26)00716-6 [Epub ahead of print].

Alzheimer's disease (AD) is increasingly recognized as a systemic disorder involving not only central neurodegeneration but also alterations in peripheral immune regulation and systemic homeostasis. Among these, the bone marrow represents a critical yet underexplored interface between the brain and systemic homeostasis. In the present study, we investigated whether AD-like neurodegeneration induces functional and structural remodeling of the bone marrow and whether these changes can be modulated through central neural stimulation and treatment with embryonic proteoglycans (PEG). An AD-like model was induced in adult male rats by intracerebroventricular administration of aggregated amyloid-β (Aβ1-42). Bone marrow alterations were assessed using ELISA for insulin-like growth factor-1 (IGF-1) and nerve growth factor (NGF), Western blot analysis of c-Fos and NF-κB, high-performance liquid chromatography for GABA determination, flow cytometry of hematopoietic and niche-associated cell populations, and morphological evaluation using hematoxylin and eosin and Giemsa staining. Additional modulation was performed by sequential electrostimulation of the hypothalamic supraoptic and paraventricular nuclei and by administration of embryonic proteins. Amyloid exposure significantly increased bone marrow IGF-1 levels, c-Fos expression, and NF-κB activation, accompanied by marked remodeling of marrow architecture characterized by reduced adiposity, increased hematopoietic cellularity, megakaryocytic abnormalities, and altered expression of progenitor-, neuronal-, and apoptosis-associated markers. Flow cytometry revealed shifts in specific CD3[+]CD3[+] T-cell subpopulations and increased apoptotic signaling, indicating dynamic reorganization of the hematopoietic niche. Hypothalamic stimulation and PEG treatment partially normalized these alterations, reducing inflammatory activation and restoring trophic and cellular balance. These findings demonstrate that AD-like neurodegeneration is associated with coordinated bone marrow remodeling and support the existence of a functional brain-bone marrow axis. The reversibility of these changes suggests that the bone marrow represents a biologically active and therapeutically accessible component of systemic responses to neurodegeneration, with potential relevance for future Alzheimer's disease interventions.

RevDate: 2026-08-20
CmpDate: 2026-08-20

Halder D, Prajapati D, Banerjee T, et al (2026)

Epigenetic modulators as therapeutics for neurodegenerative disorders/Alzheimer's disease.

Methods in enzymology, 733:163-222.

Epigenetic dysregulation is recognized as a primary contributor to the pathogenesis of neurodegenerative disorders, especially Alzheimer`s disease (AD). Epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNA regulation, govern gene expression without altering the DNA sequence, which plays a crucial role in neuronal development, synaptic plasticity, and memory formation. In AD, abnormal epigenetic alterations disrupt neuronal homeostasis, promote Aβ aggregation, tau hyperphosphorylation, and neuroinflammation, which leads to cognitive impairment. This chapter explores the assays performed and their processes using epigenetic modulators, along with their therapeutic potential in neurodegenerative diseases, especially AD. HDAC inhibitors, DNMT inhibitors, and emerging approaches, such as PROTACs for selective degradation of epigenetic enzymes, were discussed in the context of neurocognitive disorders. Preclinical and clinical evidence suggest that targeting specific HDAC isoforms (HDAC3, HDAC6, etc) can restore synaptic plasticity and improve cognitive function. This chapter further discusses recent advances, challenges in drug specificity, BBB permeability, and off-target epigenetic effects, which remain barriers to clinical translation. Case studies highlighting successful epigenetic interventions in AD models were presented to demonstrate therapeutic feasibility. Overall, epigenetic modulators present a promising therapeutic approach for neurodegeneration, and continued research integrating various assays like DNA methylation analysis, histone modification analysis, non-coding RNA analysis, neuroinflammation analysis, and functional and behavioral assays in AD models is significant in harnessing the full potential for AD treatment.

RevDate: 2026-08-21
CmpDate: 2026-08-21

Okafor NI, Abdelgader A, Abobaker M, et al (2026)

A Review of the Therapeutic Potential of Stem Cell-Derived Nanocarriers to Treat Neurological Disorders.

ChemistryOpen, 15(9):e202500425.

Neurological disorders (NDs) are characterized by substantial loss of specific neurons, with Alzheimer's and Parkinson's diseases being the most frequent NDs and nearly 99% of all "foreign substances" are prohibited from entering the brain by the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (CFB). These barriers, while crucial for brain protection, pose significant challenges for drug delivery, as they restrict the entry of many therapeutic agents into the brain, and this represents the primary manifestation of the absence of pathogenesis-targeting therapeutics. With significant success across multiple cell transplantation research efforts, stem cell therapy has been utilized for decades to treat neurological disorders. They work by replacing injured or lost cells directly, releasing proliferation and neurotrophic factors through autocrine and paracrine actions, suppressing neurological inflammation, and activation of endogenous brain progenitor cells. Nanocarriers derived from stem cells represent an innovative and promising therapeutic strategy for combating neurological diseases, combining faculties of regeneration of stem cells with the precision of nanotechnology. These nanocarriers possess natural biocompatibility and can efficiently cross the BBB to transport the therapeutic agents directly to affected neural tissues, thereby promoting enhanced treatment efficacy while reducing off-target effects. However, key challenges remain in large-scale production, standardization, and long-term safety. Thus, this review has examined the potential applications of stem cell extracellular vesicle (EV)-nanocarriers, mainly exosomes and recent development in the treatment of neurological diseases.

RevDate: 2026-08-22
CmpDate: 2026-08-21

Mehta V, Singh D, Kelman J, et al (2026)

Real-world determinants of time to initiation of anti-amyloid treatments: comparative data from private and academic practice settings.

Alzheimer's & dementia (Amsterdam, Netherlands), 18(3):e70436.

INTRODUCTION: Earlier anti-amyloid therapy (AAT) initiation results in improved clinical outcomes in Alzheimer's disease (AD). We sought to identify demographic, clinical, and disease-related factors impacting door-to-treatment times (DTTs).

METHODS: A retrospective review of AAT data was conducted at private and academic neurological practices.

RESULTS: A total of 329 patients (53.2% from private versus 46.8% academic practices), mean age 73.5 ± 7.2 (55.3% female), with most being non-Hispanic White were treated with lecanemab (81.2%) or donanemab (18.2%). DTTs were significantly reduced (p < 0.05) in both practices when diagnosis was confirmed with blood-based biomarkers (BBBs) as well as with greater clinic experience dosing AATs. DTT increased in patients with non-Medicare insurance and was not impacted by diagnosis, referral source, apolipoprotein E genotype status, or clinic distance.

DISCUSSION: Patients with private insurance may experience greater delay in DTT, whereas BBBs may reduce DTT relative to traditional confirmatory biomarkers. DTT improves with clinic experience.

RevDate: 2026-08-21

Cao Q, Shen M, Liu Y, et al (2026)

The role of microglia glucose metabolism reprogramming in Alzheimer's disease treatment.

Journal of Alzheimer's disease : JAD [Epub ahead of print].

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive impairment, and there remains a lack of effective treatments capable of reversing or significantly slowing disease progression. Accumulating evidence indicates that the immune function of microglia, the resident immune cells of the central nervous system, is a critical factor in regulating AD pathogenesis. Emerging research in immunometabolism further reveals that glucose metabolic reprogramming serves as a central driver of microglial phenotypic and functional differentiation. This review systematically outlines the fundamental characteristics of microglial glucose metabolism and focuses on how the dynamic metabolic reprogramming it undergoes during AD progression regulates microglial immune behavior and inflammatory responses. Building on this, we further summarize key regulatory targets within the "metabolism-immune axis" and corresponding pharmacological intervention strategies. Finally, this article discusses current challenges and future research directions in the field of microglial immunometabolism. This review aims to provide a theoretical foundation for AD intervention strategies targeting the "metabolism-immune axis" and to offer insights for the development of novel disease-modifying therapeutics.

RevDate: 2026-08-20
CmpDate: 2026-08-20

Copeland MH, Youngstrom DE, Konrad KS, et al (2026)

Diphenhydramine Disrupts Sleep Architecture in 5XFAD Alzheimer's Disease Model and Wild-Type Mice.

bioRxiv : the preprint server for biology pii:2026.07.22.739929.

Sleep disruption is common in Alzheimer's disease (AD). Diphenhydramine (DPH), a first-generation antihistamine with anticholinergic properties, is widely used as an over-the-counter sleep aid. We tested whether chronic DPH treatment alters sleep architecture in 5XFAD and wild-type mice. Female 5XFAD (n=16) and wild-type (WT) littermates (n=14) were implanted with wireless telemetry recording devices to measure electroencephalography (EEG), electromyography (EMG), temperature, and activity continuously. After a 24h baseline recording at 5 months of age, mice received oral DPH (10 mg/kg) or vehicle at ZT0 for one month. After this chronic treatment, sleep was recorded continuously for 48h during ongoing dosing. Sleep was scored as rapid eye movement (REM), non-rapid eye movement (NREM) 1, NREM2, or wake. A survival curve analysis was used to investigate the microarchitecture of sleep phases after chronic diphenhydramine treatment. At baseline, 5XFAD mice had more time in NREM1 than WT controls and had shorter REM and NREM2 bouts. Chronic DPH treatment fragmented NREM2 in both genotypes, reducing long NREM2 bouts. DPH increased total duration of NREM1 and REM during the active phase, which is analogous to daytime drowsiness in humans. DPH did not rescue 5XFAD sleep deficits; instead, DPH treatment exacerbated NREM2 fragmentation. Overall, chronic DPH use degrades sleep quality and increases fragmentation in both WT and AD-model mice, which questions the use of sedating anticholinergics as sleep aids, especially in AD.

RevDate: 2026-08-20
CmpDate: 2026-08-20

Wander PL, Doherty L, Pan Q, et al (2026)

Randomized metformin and cognitive outcomes in the Diabetes Prevention Program Outcomes Study.

medRxiv : the preprint server for health sciences pii:2026.08.05.26359234.

IMPORTANCE: Metformin may influence risk of dementia, with prior conflicting observations of protection or harm.

OBJECTIVE: To determine the association of randomization to metformin vs. placebo or intensive lifestyle intervention (ILS) in the Diabetes Prevention Program (DPP) with cognitive outcomes (cognitive impairment syndromes and trajectories of cognitive test performance) during the DPP Outcomes Study (DPPOS).

Prospective long-term follow-up of DPP/DPPOS participants at 27 U.S. centers among adults who were at high risk for type 2 diabetes (T2D) at baseline.

EXPOSURES: Randomization to metformin, placebo, or ILS (1996-1999) for 3.2 years followed by open-label metformin in the original randomized metformin group until 2021.

MAIN OUTCOMES & MEASURES: Cognitive impairment syndromes were adjudicated in 2022- 2024 in 1,483 participants (median age 74 [IQR 68, 80]) using the National Alzheimer's Coordinating Center Uniform Dataset version 3. Cognitive performance in executive and memory domains was ascertained with repeated cognitive tests between 2009 and 2024. Multinomial logistic regression and mixed-effects models were fit to examine associations of randomization to metformin with cognitive outcomes.

RESULTS: Total metformin exposure (mean ± SD) was 15.5 ±7.7 years/person in the metformin group. Persons in the placebo and ILS groups received out-of-study metformin usually after developing diabetes with mean metformin total exposure of 4.5 ±5.1 and 3.8 ±4.8 years/person in the placebo and ILS groups, respectively. Overall, the frequency distributions of the cognitive syndromes did not differ significantly by treatment group; however, randomization to metformin was associated with a 60% (OR 0.40 [95%CI 0.17, 0.97]) and 62% (OR 0.38 [95%CI 0.16, 0.89]) lower odds of dementia compared with placebo and ILS, respectively, after adjustment for demographics, education, income, and APOE-ε4 genotype. Randomization to metformin was also associated with significantly better memory performance over time (β=0.58; 95%CI: 0.09, 1.1; p=0.02; Cohen's d=0.1).

CONCLUSIONS AND RELEVANCE: Long-term metformin treatment is associated with a reduced risk of dementia and better memory performance among persons with pre-diabetes or T2D. Estimates were imprecise due to a limited number of dementia cases. Longer follow-up with more dementia cases is needed to confirm our findings.

KEY POINTS: Question: Is chronic metformin treatment related to the risk of dementia and cognitive impairment?Findings: Randomization to metformin in the Diabetes Prevention Program was associated with a lower risk of dementia in the Diabetes Prevention Program Outcomes Study compared with the randomization to placebo or randomization to intensive lifestyle intervention, but the overall distribution of cognitive impairment syndromes did not differ significantly by treatment group. Randomization to metformin was also related to modestly better longitudinal performance in a memory test.Meaning: Chronic metformin treatment may decrease the risk of dementia.

RevDate: 2026-08-20
CmpDate: 2026-08-20

Falahati M, Ramezannejad E, Vaez-Gharamaleki Y, et al (2026)

Determining the metabolic profile measured using ultra-high pressure liquid chromatography associated with Beta Amyloid burden in the brain in individuals with mild cognitive impairment.

Research square pii:rs.3.rs-10065374.

As the world's population ages, Alzheimer's disease (AD), a progressive neurodegenerative disorder, is becoming more common. The current diagnoses for AD are not precise enough to identify the disorder when it is possible to cure. An early indicator of Alzheimer's is the assessment of beta-amyloid by positron emission tomography (PET) score, a substantial decrease in the brain's metabolomics. Furthermore, Metabolomics can be detected by UPLC (ultra-high pressure liquid chromatography). This study investigates the link between metabolic profiles and beta-amyloid load in AD in order to shed light on possible biomarkers for disease progression. The data from 59 people who have been diagnosed with moderate cognitive impairment (MCI) is extracted from the Alzheimer's Disease Neuroimaging Initiative (ADNI). This study uses ultra-high-performance liquid chromatography (UPLC) to investigate the correlation between baseline metabolic data and changes in amyloid PET scores. Seven metabolites, including DOPA, Methionine Sulfoxide (Met.SO), Tryptophan Betaine, choline, leucine, valine, and FA (18:2), seem to have a substantial connection with amyloid PET scores. These can be used as early indications of AD progression, especially Met.SO is particularly relevant when considering time interaction. Understanding the metabolic alterations associated with amyloid load can pave the way for future research incorporating metabolites into a therapeutic treatment that can be identified as crucial to the illness's progression.

RevDate: 2026-08-20
CmpDate: 2026-08-20

McGill CJ, Christensen A, Namvari S, et al (2026)

17α-Estradiol Confers Limited Protection Against APOE4 Phenotypes in Middle-Aged Female Mice.

bioRxiv : the preprint server for biology pii:2026.08.06.743074.

Longevity-promoting interventions represent a promising strategy to mitigate brain aging and reduce Alzheimer's disease (AD) risk. The NIA Interventions Testing Program identified the weak estrogen 17α-estradiol (17αE2) as a compound that extends healthspan and lifespan in mice, with effects observed primarily in males. Our recent work demonstrated that 17αE2 healthspan benefits were modulated by human apolipoprotein E (APOE) genotype such that aging phenotypes were improved more strongly in middle-aged male mice with targeted-replacement of the AD-associated APOE4 allele compared to APOE3 , the risk neutral and most common APOE allele. Here, we tested whether APOE -dependent, AD-relevant benefits of 17αE2 observed in males extend to females. Specifically, we treated 12-month-old APOE3 and APOE4 targeted-replacement female mice for 6 months with chow containing 0 or 14.4ppm 17αE2. We find that relative to APOE3 , APOE4 genotype largely exhibits more robust systemic phenotypes associated with aging, including increased adiposity, impaired glucose tolerance, and reduced energy expenditure. Further, we observe that treatment with 17αE2 yields modest improvements in some outcomes, including decreased adiposity and increased lean mass, glucose tolerance, and energy expenditure, though significant benefits are found only in APOE4 females. In the CNS, we observed mixed effects of APOE genotype on behavioral performance and indices of brain aging, with APOE4 females performing worse in the Barnes Maze and having higher levels of the AD-related peptide soluble β-amyloid, but no APOE genotype differences in cortical lipid raft oxidative damage. In contrast to its systemic effects, 17αE2 did not significantly improve neural outcomes in APOE3 or APOE4 females. These findings address the impact of biological sex on established protective effects of a longevity-promoting intervention against APOE4 phenotypes, which have significant relevance to the prevention of age-related conditions including metabolic dysfunction, cognitive impairment and vulnerability to AD.

RevDate: 2026-08-21
CmpDate: 2026-08-20

Xue WY, Li X, Li WT, et al (2026)

Post-marketing safety signals and report-level ARIA-E stratification for lecanemab and donanemab: an integrated FAERS and WHO-VigiAccess pharmacovigilance study.

Therapeutic advances in drug safety, 17:20420986261473013.

BACKGROUND: Anti-β-amyloid monoclonal antibodies provide a disease-modifying treatment approach for Alzheimer's disease, but post-marketing safety concerns remain, particularly amyloid-related imaging abnormalities (ARIA). Real-world studies have mainly described adverse event spectra and disproportionality signals, whereas report-level amyloid-related imaging abnormalities with edema or effusion (ARIA-E) risk stratification remains less well characterized.

OBJECTIVES: To compare post-marketing adverse event profiles of lecanemab (LEC) and donanemab (DON), identify report-level factors associated with ARIA-E, and develop a machine learning model for ARIA-E risk stratification.

DESIGN: Retrospective pharmacovigilance study using spontaneous reporting databases.

METHODS: Adverse event reports for lecanemab and donanemab were analyzed using the Food and Drug Administration Adverse Event Reporting System (FAERS) and WHO-VigiAccess. FAERS disproportionality analyses were performed at the Preferred Term and System Organ Class levels using frequency-based and Bayesian methods. Time-to-onset and serious-outcome patterns were further explored. Multivariable logistic regression was used to examine factors associated with report-level ARIA-E. An extreme gradient boosting (XGBoost) model was developed using temporally split FAERS datasets with nested cross-validation and temporal external validation.

RESULTS: FAERS included 2961 lecanemab and 1542 donanemab primary suspect reports; WHO-VigiAccess included 2525 lecanemab- and 1450 donanemab-related reports. Across databases, adverse event profiles were dominated by neurological events, with ARIA-related events representing the central safety signals. Serious outcomes clustered mainly in the early treatment period and attenuated over time. In complete-case regression, no overall difference in ARIA-E reporting odds was observed between donanemab and lecanemab, whereas a significant donanemab-by-body weight interaction was identified. The XGBoost model showed modest discrimination, with area under the receiver operating characteristic curve values of 0.677 in internal validation and 0.630 in temporal external validation. Calibration was suboptimal, and decision curve analysis suggested limited net benefit mainly within low-threshold ranges.

CONCLUSION: ARIA-related and other neurological events remain the principal post-marketing safety concern for lecanemab and donanemab. The XGBoost model may support report-level risk prioritization, particularly during early treatment, but should not be used as a diagnostic substitute or a source of precise individualized risk estimates.

RevDate: 2026-08-20

Greenberg SM, Iadecola C, Chou SH, et al (2026)

Amyloid-Related Imaging Abnormalities Summit Special Proceedings: Cardiovascular and Stroke Considerations for β-Amyloid Immunotherapy in Alzheimer Disease.

Journal of the American Heart Association [Epub ahead of print].

BACKGROUND: New antiamyloid therapies (AAT) for treating patients with early Alzheimer disease (AD) have become available in the past 3 years. Although AAT can be beneficial in slowing progression of AD, they also come with potentially serious side effects, particularly for patients requiring anticoagulation or thrombolysis for cardiovascular conditions. Given that most patients with AD are older and likely to have cardiovascular risk factors, there is urgent need for additional guidance for clinicians about potential risks and benefits associated with AAT for patients with cardiovascular comorbidities, best practices for management of these patients, and special considerations with respect to emergency evaluation and treatment of patients on AAT who develop acute neurological symptoms.

METHODS: The American Heart Association convened 75 multidisciplinary experts for the Amyloid-Related Imaging Abnormalities Summit: Cardiovascular and Stroke Considerations for β-Amyloid Immunotherapy in AD in July 2025. These experts were divided into 8 work groups to evaluate the current evidence related to AAT usage in patients with cardiovascular risk factors and conditions and develop consensus-based guidance for clinicians.

RESULTS: This statement outlines the outcomes of the Summit, including considerations for prescribers, primary care professionals, emergency personnel, and health care system stakeholders. These considerations are intended to improve identification of patients as appropriate candidates for AAT, management of patients with co-occurring AD and cardiovascular conditions, and their emergency evaluation and treatment. The statement also includes guidance for shared decision-making, implementation of system changes for improving dementia care, and recommendations for future research and data collection to add to the body of evidence for treating patients with concomitant AD and cardiovascular conditions.

CONCLUSIONS: Building on lessons learned from the establishment of stroke systems of care, the consensus-based considerations outlined in this document can serve as a foundation for AD systems of care aimed at ensuring optimal use of these ground-breaking therapies.

RevDate: 2026-08-20

Fu C, Li Q, Yang Y, et al (2026)

Discovery of novel RIPK3 inhibitors by virtual screening and bioactivity evaluation.

Molecular diversity [Epub ahead of print].

As the most common chronic neurodegenerative disease, Alzheimer's disease (AD) has limited effective treatment options, highlighting the critical urgency of developing new therapeutic drugs. Receptor-interacting protein kinase 3 (RIPK3) is a key regulatory protein in the process of cell necroptosis and is also a potential target for AD. Existing inhibitors are not suitable for clinical treatment of AD due to problems such as insufficient activity, high toxicity, and poor selectivity. Therefore, the discovery of novel RIPK3 inhibitors is necessary and urgent. This study proposes and applies an integrated virtual screening strategy based on molecular fingerprint similarity, pharmacophore models, molecular docking, and molecular dynamics (MD) simulation. Using this workflow, we selected 54 compounds from approximately 9.7 million compounds for in vitro biological validation. In vitro kinase activity assays showed that three compounds (8019 - 0682, STK930700, and T72029) exhibited good inhibitory activity against RIPK3, with IC50 values of 1.684 µM, 3.002 µM, and 7.592 µM. Among them, 8019 - 0682 and T72029 demonstrated good cytoprotective effects in the TNF-α-induced L929 cell necroptosis model, with EC50 values of 2.135 µM and 15.891 µM. Finally, MD simulations and binding free energy calculations for the three compounds revealed a crucial hydrogen bond interaction with the M97 residue in the RIPK3 hinge region. In summary, this study proposes a combined virtual screening strategy and offers three promising lead compounds targeting RIPK3 for AD treatment.

RevDate: 2026-08-20
CmpDate: 2026-08-18

Biswas B, Gabb VG, Blackman J, et al (2026)

"Like Taking Part in Star Wars": Qualitative Study Using Thematic Analysis to Explore the Acceptability and Experiences of Older Adults Participating in Remote Longitudinal Sleep and Dementia Research.

Journal of medical Internet research, 28:e88094.

BACKGROUND: Sleep disturbance is a common symptom of and potential risk factor for neurodegeneration and dementia. Remote monitoring technologies and increasing digital literacy offer promise for monitoring symptoms and treatment responses via sleep and cognitive assessments from patients' homes. However, the acceptability of remote sleep and circadian research in older adults with and without cognitive impairment is not known.

OBJECTIVE: This study aimed to explore and describe the barriers, facilitators, and user experience of older adults participating in longitudinal sleep and dementia research using remote monitoring technologies.

METHODS: Older adults with mild cognitive impairment (MCI) or dementia due to probable Alzheimer disease or Lewy body disease and age-matched controls participated in an 8-week remote study involving multimodal assessments of sleep and cognition, including actigraphy, wireless electroencephalography, web-based cognitive tasks, and serial saliva samples. Participants were asked for feedback via questionnaires during the study at 2 time points and purposively invited to complete end-of-study interviews about their experiences. The Capability, Opportunity, Motivation-Behavior model of behavior change, and the extended Unified Theory of Acceptance and Use of Technology, were used to guide questionnaire and interview topic guide development. Inductive reflexive thematic analysis was undertaken, with components from the models used as sensitizing concepts.

RESULTS: A total of 14 participants (9 with MCI or dementia, 5 controls) completed end-of-study interviews, and 28 participants (9 with MCI or dementia, 19 controls) completed questionnaires. Six key themes were identified: (1) "Perceived value as motivation," (2) "Trust and simplicity as cornerstones in user experience," (3) "Adjusting to study participation over time," (4) "Adherence, accuracy, and getting it right," (5) "Social support as a facilitator and a barrier," and (6) "Reflections, realities, and uncertainties around sleep."

CONCLUSIONS: Older adults with and without cognitive impairment were motivated to engage in longitudinal remote sleep research and provide good quality data. Acceptability was related to burden, usability, and reliability of devices, having sufficient support, and ability to build study tasks into a routine. In repeated cognitive tasks, varying task content and difficulty, and allowing flexibility in timing may avoid fatigue and frustration. Future studies should aim to identify effective strategies for recruiting diverse populations, particularly those with limited technology experience or from underserved communities, to ensure equitable participation and representation in research. Providing education on the importance of sleep for brain health and technology use may be beneficial.

RevDate: 2026-08-18
CmpDate: 2026-08-18

Ahmad S, Mei J, Wang C, et al (2026)

Modulation Mechanisms of Transmembrane Domain Flexibility in Amyloid Precursor Protein and Notch: A Coarse-Grained Simulation Study on the Impact of Upper and Lower Leaflet Composition in Liquid-Ordered and Liquid-Disordered Ternary Bilayer Membranes.

Langmuir : the ACS journal of surfaces and colloids, 42(32):23197-23215.

Alzheimer's disease (AD) and Notch-related pathologies are linked to dysregulated γ-secretase cleavage of amyloid precursor protein (APP) and Notch transmembrane domains (TMDs). However, γ-secretase inhibitors for AD often disrupt Notch signaling, necessitating strategies to selectively modulate substrate cleavage. This study employs coarse-grained molecular dynamics simulations to investigate how lipid bilayer composition─specifically liquid-ordered (Lo) and liquid-disordered (Ld) phases with varying cholesterol (Chol), palmitoyl-sphingomyelin, and 1,2-dioleoyl-sn-phosphatidylcholine ratios─impacts the flexibility and stability of APP and Notch TMDs. Our key findings reveal that Chol-rich Lo phases enhance APP TMD flexibility, promoting γ-secretase cleavage and Aβ production, while Notch TMD stability is largely unaffected by Chol, favoring Ld phases, replicating perfectly the existing experimental observations and resolving several conflicting perspectives. A critical innovation lies in identifying asymmetric lipid compositions (e.g., Chol-enriched lower leaflets) as regulators of APP-Notch selectivity. These results highlight membrane microenvironment engineering as a promising therapeutic avenue to decouple APP and Notch processing. Future work should validate these findings experimentally and explore lipid-based modulators for AD treatment with reduced side effects.

RevDate: 2026-08-18
CmpDate: 2026-08-18

Oria RS, Akpang KE, Ben RB, et al (2026)

Hesperidin attenuates aluminum chloride-induced cognitive impairment by modulating ERK/MAPK Signaling, tau protein immunoexpression, neuroinflammation, and microglial activation in mice.

Metabolic brain disease, 41(1):.

Aluminum chloride (AlCl3) is widely used to model Alzheimer's-related neurotoxicity and cognitive decline. Hesperidin, a citrus flavanone with antioxidant and anti-inflammatory properties, has unclear neuroprotective mechanisms against aluminum-induced neurodegeneration. This study investigated hesperidin's neuroprotective effects against AlCl3-induced cognitive impairment in mice, focusing on ERK/MAPK signaling, tau expression, neuroinflammation, and microglial activation. Mice received AlCl3 (100 mg/kg) daily for four weeks, hesperidin (100 mg/kg), both, or vehicle, with hesperidin administered during weeks 3 and 4 in the co-treated group. Cognitive function was assessed using the Morris water maze and Y-maze tests. TNF-α and IL-1β were quantified in brain tissue. IBA1-positive microglial density, ERK immunoreactivity, and tau expression were evaluated immunohistochemically in the hippocampal CA3 region and the prefrontal cortex. AlCl3 impaired spatial and working memory, elevated pro-inflammatory cytokines, increased microglial activation, and upregulated ERK and tau immunoexpression in both regions. Hesperidin co-treatment significantly rescued cognitive deficits, attenuated neuroinflammation, reduced microglial reactivity, modulated ERK signaling, and decreased tau overexpression. These findings demonstrate that hesperidin protects against AlCl3-induced neurodegeneration by concurrently modulating neuroinflammatory and kinase-dependent pathways, supporting its therapeutic potential in aluminum-related tauopathies.

RevDate: 2026-08-18

Li Z, Sun T, Han M, et al (2026)

Deep learning-driven discovery and optimization of natural LSD1 inhibitors for the treatment of Alzheimer's disease.

Bioorganic chemistry, 181:110396 pii:S0045-2068(26)00932-6 [Epub ahead of print].

Alzheimer's disease (AD) is a prevalent neurodegenerative disorder with limited effective disease-modifying treatments. Lysine-specific demethylase 1 (LSD1) has emerged as a promising target for AD therapy. However, current LSD1 inhibitors for AD still suffer from poor brain permeability, off-target toxicity, and chemical-scaffold scarcity. Herein, we developed a multimodal deep learning model (PLM-CAFT-DTA) for drug-target affinity (DTA) prediction. This model integrates ChemBERTa, ESM-2, graph attention, and cross-attention fusion to achieve high prediction precision. Using this model combined with virtual screening and molecular simulation, we identified silybin as a hit compound from a library of over 70,000 natural products. After rational modification, compound S3 was obtained with significantly improved LSD1 inhibition (IC50 = 2.30 μM), approximately 7-fold more potent than the silybin. In vitro assays showed that S3 exhibited favorable neuroprotective and antioxidant activities. In APP/PS1 mice, S3 upregulated hippocampal H3K9me2, suppressed neuroinflammation and Aβ deposition, and improved cognitive function. By addressing unmet demands for AI-assisted anti-AD lead discovery, this study provides a generalized DTA tool for early-stage drug development, and identifies S3 as a novel LSD1 inhibitor with potent anti-AD efficacy.

RevDate: 2026-08-20

Yu Z, Wang Y, Y Yang (2026)

Autophagy as a mechanistic link between physical exercise and Alzheimer's disease.

Neuroscience, 614:307-317 pii:S0306-4522(26)00561-0 [Epub ahead of print].

Alzheimer's Disease (AD), the most prevalent cause of dementia worldwide, is a neurodegenerative disorder that currently has no cure. A growing body of evidence suggests that physical exercise is a potential non-pharmacological strategy in the treatment of AD. Recent findings highlight the involvement of autophagy in the modulatory actions of physical exercise for AD. Here, we present a narrative review of the current knowledge on how exercise impacts AD, specifically focusing on its regulation of autophagic activity in animal models of AD. Evidence from rodent studies further demonstrates that exercise may influence AD-related pathology through autophagy-lysosomal regulation, lysosomal homeostasis, and mitochondrial quality control, but direct human evidence remains limited. This review uniquely positions exercise-induced autophagy regulation as a central mechanistic hub, offering a novel paradigm for developing lifestyle-based interventions for AD.

RevDate: 2026-08-18
CmpDate: 2026-08-18

Valverde A, Blasco H, Corcia P, et al (2026)

Exploring the effect of red and near-infrared light on neurodegenerative disease: A focus on amyotrophic lateral sclerosis, Charcot's devastating disease of the motor system.

International review of neurobiology, 189:205-236.

All neurodegenerative diseases, from Alzheimer's disease to amyotrophic lateral sclerosis (ALS), are characterised by a relentless and progressive degeneration of neurones. The degenerating neurones suffer from mitochondrial dysfunction, glutamate excitotoxicity, metabolic disorder and atypical protein aggregations; there is also widespread neuroinflammation and damage to the neurovascular unit across the nervous system. Unfortunately, there is no current treatment option that addresses all, if not many, of these striking abnormalities, one that stops or even slows the progression of the disease (ie neuroprotective). In this chapter, we explore the potential effectiveness of red and near infrared light (R-NIr) on ALS, one of the most devastating of all the neurodegenerative diseases. This condition impacts the motor system, from the cerebral cortex and brainstem to the spinal cord, as well as many skeletal muscles. Individuals suffer greatly and the survival period after onset of the first signs is often very short, averaging just over 2 years, as against 4-8 years in dementia. We outline two main reasons why R-NIr may have positive outcomes in ALS; (1) R-NIr has been shown to be neuroprotective in many other neurodegenerative diseases, improving cell function and survival, and; (2) unlike many other treatments attempted previously, R-NIr addresses many, if not all features of pathology associated with ALS. In summary, we suggest that R-NIr, with its multi-modal effect, could be a valuable treatment option for patients with ALS, particularly if the treatment is started early, before the development of excessive cellular damage.

RevDate: 2026-08-19
CmpDate: 2026-08-19

Jamali MC, Shafie A, Alqahtani AJ, et al (2026)

Advances in the clinical application of mesenchymal stem cells for neurological disorders.

Stem cell research & therapy, 17(1):.

Therapeutic approaches employing mesenchymal stem cells (MSCs) have emerged as a promising avenue for investigating treatments for neurological disorders. This strategy aims to capitalize on the biological properties of MSCs to support the repair of damaged neural tissue and modulate pathological processes. This review provides a comprehensive overview of the current clinical evidence regarding MSC applications in major neurological disorders, including Parkinson's disease (PD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), stroke, spinal cord injury (SCI), and other pertinent disorders. Across clinical studies, MSC administration has generally demonstrated a favorable safety profile and procedural feasibility. However, therapeutic efficacy remains variable and inconsistent across trials. Importantly, differences in MSC sources, manufacturing procedures, delivery routes, dosing strategies, and patient selection contribute substantially to the heterogeneity of reported outcomes. Therefore, the current body of evidence supports the safety of MSC-based interventions, but their clinical effectiveness has not yet been consistently demonstrated. Future progress will depend largely on the standardization of cell preparation and treatment protocols, improved biomarker-driven patient stratification, and rigorously designed large-scale randomized trials.

RevDate: 2026-08-19

Abubakar MD, Dahiya R, Nama L, et al (2026)

An Innovative Strategy for Treating Neurodegenerative Disorders through Exosome-based Smart Delivery Systems: A Comprehensive Review.

CNS & neurological disorders drug targets pii:CNSNDDT-EPUB-157552 [Epub ahead of print].

Alzheimer's and Parkinson's diseases are devastating brain disorders. The complex pathophysiology of the diseases and the lack of effective treatments have left them almost unexplored and untreatable. One potential approach to PD and AD therapy development is through exosomes, a delivery system that can be translated from innovative delivery techniques into clinical use. These exosome-based therapeutics will require thorough testing, research-driven refinement of engineering methods, and collaboration among scientists, clinicians, and industry to develop exosome therapeutics for clinical use. This review explores the biological properties of exosomes, recent engineering advances to improve their therapeutic potential, and new methods to leverage their versatility for selective delivery of remedial agents to the brain. In addition, preclinical evidence demonstrates that exosomes can modulate amyloid-β aggregation, α-synuclein pathology, neuroinflammation, and mitochondrial dysfunction. Yet difficulties related to mass production, maintaining quality, and obtaining regulatory approvals to bring them into clinical practice remain significant limiting factors. The authors point out the therapeutic advantages and drawbacks of exosome-based drug delivery systems. Besides, it provides a roadmap for harnessing these methods effectively as medical interventions for Alzheimer's and Parkinson's disorders, thereby promoting more studies in the area. Finally, we outline a conceptual model for translating novel exosome-based delivery methods into clinically applicable treatment modalities for Alzheimer's and Parkinson's diseases, thereby encouraging continued exploration in this promising field of research.

RevDate: 2026-08-19

Sharma A, P Singh (2026)

Synergistic Role of Caffeic Acid with Conventional Neuroprotective Drugs: Potential of Combination Therapy for Managing Alzheimer's Disease.

Recent advances in inflammation & allergy drug discovery pii:RAIAD-EPUB-157577 [Epub ahead of print].

INTRODUCTION: Alzheimer's Disease (AD) is a complex neurodegenerative disease involving amyloid-β accumulation, formation of neurofibrillary tangles, oxidative stress, and inflammation. Current treatment options include symptomatic agents such as Acetylcholinesterase Inhibitors (AChEIs) and memantine. The present review discusses the therapeutic potential of Caffeic Acid (CA) as an adjunctive agent to conventional anti-Alzheimer's treatments, focusing particularly on its pharmacodynamics and pharmacokinetics.

METHODS: An extensive search of the literature was carried out from the years 2000 to 2025 using databases such as PubMed, Scopus, Web of Science, Science Direct, Embase, Medline, Google Scholar, and others. All in vitro, in vivo, and in silico studies that have evaluated CA alone or in combination with AChEIs and memantine were included.

RESULTS: The existing literature suggests that CA has antioxidant, anti-inflammatory, and weak cholinesterase inhibition properties, while AChEIs and memantine mainly target neurotransmission. The results suggest that CA, when combined with other anti-Alzheimer's agents, provides superior neuroprotective properties compared to monotherapy in various animal models. Nevertheless, current data support more additive rather than synergistic actions of CA with AD medications.

DISCUSSION: Pharmacokinetic issues associated with CA use are possible due to the drug's ability to interfere with cytochrome P450 and P-glycoprotein. Moreover, issues with CA pharmacokinetics, nanoparticle delivery systems, and patient compliance might affect the translation of these findings into clinical practice.

CONCLUSION: CA might be used as an auxiliary substance for treating AD. Further research on pharmacokinetic/pharmacodynamic interactions and synergy between these compounds is required.

RevDate: 2026-08-19

Kulan H (2026)

Proteomic Basis of Polypharmacological Cognitive Recovery in Down Syndrome and Alzheimer's Disease.

Current Alzheimer research pii:CAR-EPUB-157551 [Epub ahead of print].

INTRODUCTION/OBJECTIVE: Down Syndrome (DS) is a genetic disorder caused by trisomy of human chromosome 21 and represents the most common genetic cause of intellectual disability. It is also associated with an increased risk of developing Alzheimer's Disease (AD). Although various pharmacological treatments have been shown to improve learning and memory in DS models, the underlying mechanisms of cognitive improvement remain poorly understood. This study aims to identify molecular signatures associated with pharmacological cognitive rescue across different brain regions using a machine learning-guided targeted proteomics approach.

METHODS: Gradient Boosting Tree (GBT)-based feature selection combined with Principal Component Analysis (PCA) was applied to identify reproducible proteomic signatures in cortical samples from memantine-treated mice and in hippocampal samples from RO4938581-treated mice.

RESULTS: GBT models achieved classification accuracies exceeding 80% across experimental groups, and PCA showed distinct group separation, with PC1 and PC2 accounting for more than 60% of the total variance. The consistently identified proteins across datasets include APP, RCAN1, S6/pS6, IL1B, BAX, TAU, AMPKA, BRAF, ERK, and ADARB1.

DISCUSSION: The identified proteins converge on interconnected networks linking synaptic signaling, metabolic regulation, and neuroinflammation, reflecting pathways involved in Excitation/İnhibition (E/I) imbalance and neurodegeneration. Their consistency across datasets implies that coordinated regulation of these networks, rather than isolated pathway effects, is associated with cognitive improvement. Specifically, the MAPK-ERK and AMPK-mTOR signaling pathways emerge as key integrative nodes connecting synaptic function, energy balance, and cellular stress responses. These results point to possible mechanistic overlap with Alzheimer's disease-related pathology and support a network-based, multi-target model of cognitive improvement in DS.

CONCLUSION: These results demonstrate that different pharmacological treatments converge on shared protein signatures associated with cognitive improvement in DS. This convergence supports a network- based, multi-target therapeutic approach, in which modulation of key regulatory nodes rather than single targets may underlie effective treatment strategies.

RevDate: 2026-08-20
CmpDate: 2026-08-19

Meng Z, Wu H, Miao Y, et al (2026)

Association between different sodium-glucose co-transporter 2 inhibitors and the risk of dementia: a network meta-analysis.

Frontiers in endocrinology, 17:1777151.

BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i), as key therapeutic agents for type 2 diabetes, have in recent years been recognized as potentially exerting neuroprotective effects on the central nervous system. However, systematic comparative evidence remains lacking regarding whether different SGLT2i exhibit differential effects on dementia risk. By conducting a network meta-analysis to compare the association between different SGLT2i and the risk of dementia onset, the relative efficacy of each drug in reducing dementia risk is determined.

METHODS: A systematic search was conducted across databases including PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to the search cutoff date of 1 December 2025. Randomized controlled trials and observational studies comparing SGLT2i with other antidiabetic medications or placebo, and reporting dementia outcomes, were included. A network meta-analysis employing a random-effects model was conducted. Pooled effect sizes were expressed as hazard ratios with 95% confidence intervals. Relative efficacy among different drugs was ranked using the probability of ranking, whilst heterogeneity and consistency were assessed.

RESULTS: Six cohort studies involving 845,433 patients were included in this analysis. The results of the network meta-analysis indicated that canagliflozin (HR = 0.75, 95% CrI: 0.59, 0.98), Dapagliflozin (HR = 0.75, 95% CrI: 0.59, 0.98), and Empagliflozin (HR = 0.69, 95% CrI: 0.55, 0.85) significantly reduced the risk of dementia onset. Empagliflozin had the highest probability of being ranked as the most effective treatment (81.2%). However, no statistically significant differences were observed between empagliflozin and dapagliflozin or canagliflozin in the network comparisons. For Alzheimer's disease, Dapagliflozin (HR = 0.68, 95% CrI: 0.48, 0.96) and Empagliflozin (HR = 0.62, 95% CrI: 0.45, 0.87) also demonstrated significant risk reduction, whilst direct comparisons between Empagliflozin and other agents showed no significant differences. For vascular dementia, Empagliflozin (HR = 0.63, 95% CrI: 0.46, 0.87) and Canagliflozin (HR = 0.71, 95% CrI: 0.48, 0.98) also demonstrated favorable outcomes.

CONCLUSIONS: The findings of this study indicate that dapagliflozin, empagliflozin, and canagliflozin, particularly empagliflozin, demonstrate significant potential in reducing the incidence of dementia and related cognitive impairments. Compared with DPP-4 inhibitors, these agents effectively lower the risk of dementia, Alzheimer's disease, and vascular dementia, offering an effective therapeutic option for diabetic patients, particularly the elderly.

RevDate: 2026-08-19
CmpDate: 2026-08-19

Singh SK, Dinodiya H, Parihar S, et al (2026)

Engineering ApoE3-Targeted NIR-Responsive Liposomes for Multimodal Inhibition of Amyloid-β Aggregation and Acetylcholinesterase Activity.

ACS chemical neuroscience, 17(16):3094-3108.

Alzheimer's disease (AD) is characterized by progressive neurodegeneration and cognitive decline, largely driven by amyloid-β (Aβ) aggregation and dysregulated acetylcholinesterase (AChE) activity. While current pharmacological interventions utilize AChE inhibitors and Aβ antagonists, their efficacy is frequently hampered by monotherapeutic limitations, poor blood-brain barrier (BBB) permeability, and a lack of controlled release mechanisms. Herein, we report the engineering of the liposomal formulation coloaded with Donepezil (DNP) and the photothermal agent indocyanine green (ICG), followed by conjugation of ApoE3 protein (LIDA) designed for multimodal AD therapy. Surface-conjugated ApoE3 serves a bifunctional role by facilitating BBB penetration and actively inhibiting Aβ oligomerization. Upon 808 nm laser irradiation, ICG-mediated photothermal induction triggers the spatiotemporal release of DNP, significantly enhancing AChE inhibition. Furthermore, LIDA treatment effectively mitigates Aβ-induced cytotoxicity and mitochondrial dysfunction in SH-SY5Y cells. By integrating targeted delivery with NIR responsiveness, this study presents a novel, multivalent strategy to combat the complex pathological landscape of AD.

RevDate: 2026-08-19

Hu CJ, Huang YH, Cho S, et al (2026)

Epidemiology, Patient Characteristics, Treatment Patterns, and Costs of Mild Cognitive Impairment and Alzheimer's Disease in Taiwan.

Value in health regional issues pii:S2212-1099(26)00102-0 [Epub ahead of print].

OBJECTIVES: Alzheimer's disease (AD) with mild cognitive impairment (MCI) and AD are stages along the cognitive decline continuum and represent growing public health concerns. This study aimed to assess the diagnosed prevalence, claims-identified incidence, treatment patterns, healthcare costs, comorbidities, and observed mortality outcomes of individuals with AD with MCI, and AD with dementia in Taiwan claims data over a 10-year period.

METHODS: We conducted a retrospective cohort study using Taiwan's National Health Insurance Research Database. Individuals diagnosed with AD with MCI, or AD, between 2013 and 2022 were identified via ICD-9-CM and ICD-10-CM codes. Cross-sectional and longitudinal analyses examined epidemiology, treatment trends, costs, comorbidities, and mortality using descriptive statistics, survival analysis, and cost evaluations.

RESULTS: The estimated prevalence of AD with MCI, and AD from the claims database, increased from 109 379 cases in 2018 to 131 053 in 2022. Among pharmaceutical interventions, donepezil usage was predominant and increased over time, whereas nonpharmacologic therapies remained minimal. Healthcare costs rose with disease severity, with nonpharmacological inpatient care being the highest expense. Cardiovascular and metabolic comorbidities were prevalent and increased with severity. Observed cumulative mortality proportions increased with advancing disease severity; patients with AD with severe dementia had the highest mortality burden (41.98% at year 3).

CONCLUSION: AD with MCI and AD with dementia prevalence estimation is rising, demonstrating increasing costs and high comorbidity burdens. Disease severity is linked to higher mortality, reinforcing the need for integrated care and early cost-effective interventions to optimize outcomes in AD with MCI and AD with patients with dementia.

RevDate: 2026-08-19
CmpDate: 2026-08-19

Jonsdotter A, Leverin AL, Svedin P, et al (2026)

Exendin-4 improves neurodevelopmental outcome after neonatal germinal matrix hemorrhage.

Cell death & disease, 17(1):.

Germinal matrix hemorrhage (GMH) is a common complication in premature infants and is associated with a high risk of neurodevelopmental impairment and mortality. Currently, there are no specific neuroprotective treatments available. Exendin-4 is a drug used for the treatment of type 2 diabetes mellitus, and it has shown neuroprotective effects in several neurological disorders including Alzheimer's and Parkinson's disease. In this study, we used the preterm postnatal day 5 rat model of GMH to evaluate whether exendin-4 exerts neuroprotective effects in this setting. Our results show that in the acute phase, exendin-4 reduced microglial activation, caspase-3 activation, p53 expression, AIF-associated cell death, MMP-9 expression, and neutrophil infiltration into the hemorrhage site. Exendin-4 treatment improved neurodevelopmental outcomes in both negative geotaxis and eye-opening latency when compared to saline-treated GMH controls, and conferred gray and white matter protection as early as 48 h after injury, with persistent neuroprotection observed at 5, 11, and 35 days after GMH. Exendin-4-treated animals also showed significant recovery of motor function in the rotarod test. In summary, this study demonstrates that exendin-4 reduces brain injury in a rat model of GMH in both the short and long term and is associated with improved neurological outcome.

RevDate: 2026-08-20

Oishi K, Adams R, Nowrangi MA, et al (2026)

Utilizing routinely acquired clinical neuroimaging and electronic health record data to advance precision medicine in dementia care.

International review of psychiatry (Abingdon, England) [Epub ahead of print].

Alzheimer's disease (AD) exhibits significant clinical variability in symptom onset, progression rates, neuropsychiatric symptoms and treatment responses. This variability reflects a range of underlying biological, genetic and environmental factors. This review summarizes recent advances in leveraging real-world electronic health records (EHRs) and clinical brain MRI to enhance precision medicine in dementia care. Traditional MRI research has identified consistent subtypes of atrophy associated with AD. However, these models often struggle to apply to routine clinical imaging, which can vary widely in contrast, resolution and acquisition protocols. Recent technological developments now allow for reliable measurement of gray matter, white matter, brainstem and cerebellar structures from routine clinical scans, effectively overcoming long-standing limitations of conventional neuroimaging methods. Additionally, efforts in EHR analysis, including the use of natural language processing on unstructured clinical notes, have enabled large-scale extraction of cognitive scores, neuropsychiatric symptoms and treatment responses. By integrating structured EHR data with detailed imaging markers, researchers have enabled predictive modeling of cognitive decline and treatment responses, though generalizability across settings remains a challenge. Federated learning frameworks offer a privacy-preserving approach to collaboratively develop models across multiple institutions. Together, these strategies outline a practical, data-driven approach to individualized diagnosis, prognosis and treatment planning for dementia.

RevDate: 2026-08-19
CmpDate: 2026-08-18

Swane V, B Biering-Sørensen (2026)

Posterior cortical atrophy with initial psychiatric presentation: a case report.

Journal of medical case reports, 20(1):.

BACKGROUND: Posterior cortical atrophy (PCA) is a rare neurodegenerative syndrome most commonly associated with atypical Alzheimer's disease. It is characterized by progressive visuospatial and visuoperceptual deficits with relative sparing of memory and language in early stages. Diagnosis is frequently delayed or missed due to clinical heterogeneity, subtle early symptoms, and limited sensitivity of routine cognitive screening tools. Psychiatric symptoms may further obscure the underlying neurological disorder. This case highlights the diagnostic challenges posed by PCA presenting in the context of prominent psychiatric symptoms, combined with a rapid clinical decline.

CASE PRESENTATION: A 68-year-old white Danish male presented with suicidal ideation and was initially admitted to a psychiatric ward. He had a remote history of a suicide attempt and a family history of suicide but no known neurodegenerative disease. Within a short period, severe cognitive and functional impairment became evident, dominated by visuospatial deficits, apraxia, simultanagnosia, optic ataxia, and features of Gerstmann and Balint syndromes, with relative preservation of memory and language. Neuroimaging revealed marked posterior cortical atrophy and parieto-occipitotemporal hypometabolism with sparing of the posterior cingulate cortex. Cerebrospinal fluid analysis showed mildly reduced amyloid-β1-42 and markedly elevated neurofilament light chain levels. Electroencephalography demonstrated focal posterior slowing without epileptiform activity. Extensive evaluation excluded autoimmune, epileptic, metabolic, and prion-related causes. Based on the clinical syndrome, characteristic neuroimaging findings, and supportive CSF biomarkers, a diagnosis of posterior cortical atrophy likely related to underlying Alzheimer's disease pathology was made. Disease-specific treatment was discussed but not initiated due to patient preference.

CONCLUSIONS: This case illustrates how posterior cortical atrophy may be overlooked, particularly when psychiatric symptoms dominate the initial presentation. It underscores the importance of considering neurodegenerative disorders in older patients with atypical psychiatric presentations or unexplained functional decline. Early recognition of PCA is crucial for accurate diagnosis, appropriate counseling, and tailored supportive care.

RevDate: 2026-08-18
CmpDate: 2026-08-18

Long W, Yuan M, Wang S, et al (2026)

The mitophagy-inflammasome axis: a shared pathological hub in Alzheimer's and Parkinson's diseases.

Translational neurodegeneration, 15(1):.

Alzheimer's disease (AD) and Parkinson's disease (PD) represent the most prevalent chronic neurodegenerative disorders, characterized by progressive loss of neurons as a core pathological feature. Despite discrepancies in their clinical phenotypes and signature pathological proteins, accumulating evidence has validated a common molecular pathogenic mechanism: dysfunctional bidirectional crosstalk between mitophagy and inflammasomes. As the central hub of neuronal energy metabolism, mitochondrial impairment triggers the release of damage-associated molecular patterns such as reactive oxygen species and mitochondrial DNA, which in turn activate inflammasomes (e.g., NLRP3) to elicit chronic neuroinflammation. Conversely, excessive inflammasome activation suppresses mitophagy, exacerbating the accumulation of damaged mitochondria and pathological protein aggregates, and forming a pathological mitochondrial damage-inflammatory activation-autophagy inhibition cycle. Microglia and astrocytes, key immunocompetent cells of the central nervous system, act as a hub within this regulatory network. Therapeutic strategies targeting the mitophagy-inflammasome axis have achieved remarkable advancements, including mitophagy agonists, inflammasome inhibitors, and dual-target modulators. This review summarizes recent findings regarding the pathogenic roles of β-amyloid and α-synuclein in AD and PD, as well as the protective effects offered by regulating mitophagy and inflammasome activity. Furthermore, the major directions and potential hurdles in the development of targeted therapeutics are discussed, in the aim of providing insights into the novel therapeutic avenues for the treatment of both disorders.

RevDate: 2026-08-19
CmpDate: 2026-08-18

Huang J, Li X, Zhou K, et al (2026)

High-frequency taVNS modulates olfaction-related brain activity in patients with subjective cognitive decline.

Frontiers in human neuroscience, 20:1888005.

BACKGROUND: Subjective cognitive decline (SCD) is considered a high-risk factor for Alzheimer's disease and serves as a critical window of the prevention and treatment. Transcutaneous auricular vagus nerve stimulation (taVNS) has shown therapeutic effects on cognitive impairment, but there is a lack of research on its application in SCD.

PURPOSE: This study aimed to explore the immediate modulatory effects of taVNS at different frequencies on the brain function in patients with SCD.

METHODOLOGY: Seventy SCD and 49 healthy control (HC) were enrolled. Resting-state functional MRI data were collected at baseline and during taVNS with three stimulation conditions: 1 Hz-taVNS, 20 Hz-taVNS, and sham taVNS (staVNS), respectively. Regional homogeneity (ReHo) analysis was used to identify spontaneous neural activity changes in SCD; the abnormal brain regions were then used as seed for subsequent functional connectivity (FC) analysis. In addition, ReHo and FC analyses were performed to assess the immediate modulatory effects of taVNS in SCD.

RESULTS: Compared with HC, SCD showed abnormal ReHo and FC mainly involving olfaction-related brain regions, and the reduced value was positively associated with Shape Trail Test-part B. During taVNS, we found that 20 Hz-taVNS significantly increased ReHo in the bilateral olfactory cortex compared with baseline, and decreased FC between the left medial orbitofrontal cortex and the right precentral and postcentral gyri. No significant ReHo or FC changes were observed during 1 Hz-taVNS and staVNS.

CONCLUSION: These findings suggest that SCD exhibits reduced spontaneous activity and disrupted FC in the olfaction-related brain regions, which may reflect early functional alterations before objective impairment; 20 Hz-taVNS can modulate these cerebral functional abnormalities and may hold potential as a noninvasive neuromodulation strategy in SCD.

RevDate: 2026-08-19
CmpDate: 2026-08-18

Umbria M, Exposito J, Gasol M, et al (2026)

A regional registry ensures clinical guideline adherence and economic sustainability of Alzheimer's disease treatment: a 12-year population-based study in Catalonia.

Frontiers in pharmacology, 17:1848809.

Population-based registries for Alzheimer's disease pharmacological treatment are essential tools for monitoring clinical guideline adherence and health system sustainability. This retrospective observational study analyzes 12 years of real-world data from the Catalan Registry of Pharmacological Treatment of Alzheimer's Disease (RTFMA) between 2012 and 2024. Analyzing a cohort of over 158,000 patients treated with acetylcholinesterase inhibitors or memantine, we found that the treated population increased by 24.5%, reaching 56,874 individuals in 2024. The implementation of a mandatory registration system was associated with high clinical appropriateness, with 81.9% of treatments initiated at recommended moderate stages (GDS 4-5), while only 8.6% began at mild stages. Despite the aging population and the impact of the COVID-19 pandemic-which caused a transient decline in treatment initiations in 2020-the system demonstrated resilience with a full recovery by 2023. Treatment discontinuation was primarily driven by mortality (95% of known reasons), indicating high persistence until end-of-life. From an economic perspective, Alzheimer's therapies represented a stable 1.9% of the total public pharmaceutical budget in 2023, reflecting effective cost containment through generic drug use. These findings suggest that a centralized, guideline-linked registry optimizes patient selection and maintains the economic viability of Alzheimer's care, providing a robust framework for the future integration of high-cost disease-modifying therapies.

RevDate: 2026-08-19

Eldehna WM, El-Damasy AK, Lim J, et al (2026)

Quinazolinone-triazole hybrids as multi-target-directed ligands for Alzheimer's disease: discovery of potent and selective MAO-B inhibitors with cholinesterase modulating activity.

RSC advances [Epub ahead of print].

A new series of quinazolinone-triazole hybrids (QTHs, 5a-n) was designed, synthesized, and evaluated as potential multi-target-directed ligands for Alzheimer's disease. All synthesized compounds were screened against human monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B). The obtained results revealed pronounced selectivity toward MAO-B, with IC50 values ranging from 0.65 to 7.51 µM, while exhibiting negligible MAO-A inhibition (IC50 > 40 µM). Compounds 5a, 5d, 5g, 5h, and 5m emerged as the most potent and selective MAO-B inhibitors and were subsequently evaluated for inhibition of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). Among them, compound 5h displayed the most favorable biological profile, showing potent inhibition of MAO-B (IC50 = 0.65 µM), AChE (IC50 = 0.084 µM), and BuChE (IC50 = 0.667 µM). In silico ADMET analysis indicated acceptable drug-like properties for the lead compounds. Furthermore, molecular docking studies against MAO-B and AChE revealed favorable binding interactions, while a 500 ns molecular dynamics simulation confirmed the stability of the 5h-MAO-B complex. Collectively, the present findings identify compound 5h as a promising lead candidate and highlight quinazolinone-triazole hybrids as attractive scaffolds for the development of selective MAO-B inhibitors with additional cholinesterase inhibitory activity for Alzheimer's disease treatment.

RevDate: 2026-08-18

Hiruta Y, Jin Z, Adachi M, et al (2026)

Protease-Triggered Chromogenic Release From Peptide-Modified Calcium Carbonate Microspheres Enables Colorimetric Detection of Porphyromonas gingivalis Activity.

Advanced science (Weinheim, Baden-Wurttemberg, Germany) [Epub ahead of print].

Porphyromonas (P.) gingivalis is a Gram-negative anaerobic bacterium with exceptionally high pathogenicity among periodontal pathogens. It is associated not only with periodontal disease but also with various systemic diseases, including Alzheimer's disease, rheumatoid arthritis, and atherosclerosis. Therefore, early detection of this bacterium is crucial for enabling subsequent treatment and prevention of such conditions. Herein, we report a chromogenic release-based assay system utilizing calcium carbonate microspheres and a dye-labeled peptide that is selectively cleaved by an Arg-specific protease called gingipain (RgpB) that is secreted by P. gingivalis. By utilizing the reactive anhydride functional groups of poly(isobutylene-alt-maleic anhydride), we simultaneously achieved the conjugation of the dye-labeled peptide and its immobilization onto calcium carbonate microspheres. Through optimization of the peptide sequence and the surface modification density on calcium carbonate microspheres, the assay of RgpB detection with the absorbance of supernatant exhibited a low limit of detection of 0.25 nM, as well as high storage stability and selectivity for P. gingivalis. The measurements obtained with this assay system for clinical gingival crevicular fluid samples showed a high correlation (Pearson's r = 0.79) with qPCR results. This assay system offers an on-site, visual means to monitor P. gingivalis activity without requiring specialized instrumentation.

RevDate: 2026-08-18

Dodart CA (2026)

The locus coeruleus gateway hypothesis: Noradrenergic integrity as a candidate determinant of amyloid-β clearance efficiency in anti-amyloid immunotherapy for Alzheimer's disease.

Journal of Alzheimer's disease : JAD [Epub ahead of print].

Anti-amyloid immunotherapies (lecanemab, donanemab) produce statistically significant but clinically modest slowing of decline in early Alzheimer's disease (AD), with substantial inter-individual response variability that current covariates-antibody titer, baseline amyloid load, apolipoprotein E ε4 (APOE4) status, or tau burden-leave largely unexplained. We propose that a systematically unmeasured upstream variable contributes to this variability: the structural integrity of the locus coeruleus (LC), the principal source of brain norepinephrine (NE), framed as a candidate determinant of amyloid-β (Aβ) clearance efficiency rather than of overall clinical outcome. This hypothesis paper synthesizes three peer-reviewed lines of evidence and derives a hierarchy of falsifiable predictions; no new data are reported. First, tau pathology initiates in LC neurons before any cortical structure, reducing NE output from the earliest preclinical stage. Second, NE governs two complementary Aβ-clearance pathways: glymphatic flow, via aquaporin-4 dynamics driven by slow LC oscillations during non-REM sleep, and microglial phagocytosis, via β2-adrenergic receptor signaling. Third, in Parkinson's disease, the DTI-ALPS index mediates the relationship between LC integrity on neuromelanin-sensitive MRI and cognition. We term this the Locus Coeruleus Gateway Hypothesis (LCGH). Its mediation chain is testable now in ADNI, which holds research-grade diffusion-tensor imaging; its treatment-response prediction requires immunotherapy cohorts that acquire such imaging, not the existing CLARITY-AD or TRAILBLAZER-ALZ 2 archives, whose safety MRI used diffusion-weighted, not tensor, sequences. We state explicitly that Aβ clearance is only one contributor to clinical benefit, and that the LCGH predicts pharmacodynamic efficiency, not that NE restoration treats AD.

RevDate: 2026-08-14

Koh H, Choi S, JE Sung (2026)

Verb-Semantic Feature Analysis for Alzheimer's Dementia in a verb-final language: evidence from Korean.

Neuropsychological rehabilitation [Epub ahead of print].

This study examined the effects of Verb-Semantic Feature Analysis (Verb-SFA) on verb naming, noun retrieval, sentence comprehension, and discourse production in individuals with Dementia of the Alzheimer's Type (DAT). Given the lexical-semantic degradation characteristic of DAT and the central role of verbs in Korean, a verb-final language, this study evaluated whether Verb-SFA facilitates treatment, near-transfer, and far-transfer effects. Three male participants, aged 60 or older with 16 years of education, completed 17 sessions: pre-treatment (4 sessions), treatment (10 sessions), and post-treatment (3 sessions). Treatment effects were assessed using 45-item probe sets derived from the Korean Item Selection Naming Test. Results showed significant improvement in naming accuracy for treated verbs, with a robust interaction between treatment sessions and treated items. No significant near-transfer effects were found for untreated verbs in the probe set or on the Action Naming Test. However, significant near-transfer effects were observed for noun retrieval on the Korean-Boston Naming Test, although verbal fluency tasks showed no improvement. Far-transfer effects emerged in sentence comprehension, suggesting strengthened verb-semantic processing supports higher-level linguistic abilities. No measurable gains were observed in discourse production. Overall, Verb-SFA treatment enhanced verb naming and sentence comprehension in individuals with DAT.

RevDate: 2026-08-16
CmpDate: 2026-08-15

Azimzadeh M, Ababzadeh S, Kahaki AG, et al (2026)

The Gut-Brain Axis in Neurodegeneration: Mechanistic Links Between Dysbiosis and Neuropathology.

Iranian journal of pathology, 21(4):507-522.

BACKGROUND & OBJECTIVE: The gut-brain axis is essentially a two-way communication system that physically connects the brain and the intestinal tract. The connection is mediated through a series of pathways, including neural, endocrine, and immune pathways. Gut dysbiosis, which is explained as an imbalance in the microbial community, has been linked to the causation of various neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, and multiple sclerosis. However, the pathological mechanisms in the brain are only partially known. The present review outlines the process of gut dysbiosis and neurodegeneration, detailing the roles of protein aggregation, neuroinflammation, barrier disruption, and neuroglial dysfunction. Then, extending the comparison to a range of neurodegenerative diseases, we discuss the possibility of common pathway therapeutics and actual microbiome-based treatment options planning from the standpoint of microbiome-directed interventions.

CONTENT/FINDINGS: Gut dysbiosis triggers a definable cascade, starting with the disruption of the intestinal barrier and increased permeability (leaky gut), which allows bacterial products (lipopolysaccharides, bacterial amyloids) and pro-inflammatory cytokines to enter systemic circulation. Such peripheral changes weaken the blood-brain barrier and thus allow these factors to access the CNS, where they lead to neuroglial dysfunction (microglial priming, astrocytic reactivity, and oligodendrocyte injury) by disruption of glial homeostasis. CNS glial cell malfunction leads to the development of proteinopathies characteristic of each disease: amyloid and tau hyperphosphorylation in Alzheimer's disease through BACE1 upregulation and kinase activation; synuclein in Parkinson's disease via molecular mimicry, oxidative stress, and impaired clearance; and demyelination in multiple sclerosis through oligodendrocyte apoptosis. Oral bacteria such as Porphyromonas gingivalis aggravate this inflammatory loop through the direct invasion of the CNS and proteolytic cleavage of amyloid and tau. The vagus nerve is yet another pathway through which gut-derived inflammatory signals and pathological synuclein can be transmitted to the brain.

CONCLUSION: The gut microbiome is more than just a correlate of neurodegeneration; it actively promotes neurodegenerative diseases through pathways that can be mechanistically defined. Microbiome-targeted interventions such as dietary changes, precision probiotics, fecal microbiota transplantation, and anti-inflammatory agents offer a measure of hope for changing these pathological processes. Future studies need to be directed at determining the time sequence of cause and effect, finding dependable microbiota-based biomarkers, and formulating tailored strategies that can account for individual microbial composition variability, genetic susceptibility, and environmental exposures. A deeper understanding of the gut-brain axis from this mechanistic perspective could eventually lead to the prevention or postponement of neurodegeneration.

RevDate: 2026-08-18
CmpDate: 2026-08-15

Tarbiat S, N Kantarci-Carsibasi (2026)

Dual inhibitory potential of N-methylcytisine against GSK-3β and AChE: implications for Alzheimer's disease treatment.

Open life sciences, 21(1):20251363.

Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by memory loss and irreversible cognitive decline. Glycogen synthase kinase 3β (GSK-3β) is significant in tau hyperphosphorylation and neurodegeneration. The cholinergic hypothesis of AD links cognitive impairment to reduced synaptic acetylcholine (ACh). Increased acetylcholinesterase (AChE) activity exacerbates this issue. To search for a potential dual GSK-3β/AChE inhibitor, we focused on N-methylcytisine. This natural cytisine-derived alkaloid has not been studied for its various biological effects on the prevention of AD. The in vitro results indicated that N-methylcytisine displayed promising activity against GSK-3β and AChE with IC50 values of 11 and 22.7 µM, respectively. GSK-3β kinetic study according to the varying substrate or ATP concentrations at different N-methylcytisine levels revealed mixed-type inhibition. The results of the integrated in silico workflow indicate that N-methylcytisine exhibited favorable binding to AChE (docking score -9.6 kcal/mol; MM-GBSA -70.2 kcal/mol), comparable to the reference inhibitor galantamine (-10.8 kcal/mol; -70.6 kcal/mol). In contrast, its interaction with GSK-3β was more moderate (-5.3 kcal/mol; -50.3 kcal/mol) relative to staurosporine (-8.5 kcal/mol; -82.6 kcal/mol), consistent with its smaller scaffold. Overall, the results support a flexible, mixed-type interaction profile and highlight N-methylcytisine as a promising dual-acting candidate for Alzheimer's disease.

RevDate: 2026-08-16
CmpDate: 2026-08-15

Dwivedi AK, Imbimbo BP, Abanto J, et al (2026)

Comparison of double-blind and open-label decline rates in lecanemab and donanemab trials in Alzheimer's disease.

BMJ neurology open, 8(2):e001649.

BACKGROUND: Phase 3 trials of the anti-amyloid monoclonal antibodies lecanemab and donanemab in Alzheimer's disease demonstrated modest slowing of cognitive decline over 18 months. Subsequent open-label extensions (OLE) suggested greater long-term benefit based on comparisons with historical untreated cohorts, which are vulnerable to selection and attrition bias.

METHODS: We simulated longitudinal Clinical Dementia Rating-Sum of Boxes trajectories using mixed-effects models calibrated to reproduce published means, variances and attrition patterns from the Clarity-AD and TRAILBLAZER-ALZ 2 trials, separately for early- and delayed-start cohorts and in combined analyses. Observed annualised slopes were also directly compared between double-blind (DB) and OLE phases. Placebo effects were estimated by comparing DB placebo arms with matched untreated historical cohorts derived from published natural history data.

RESULTS: Simulations closely reproduced reported trajectories. In both trials, the early-start cohorts showed significantly faster annualised decline during OLE than during DB treatment (lecanemab ∆=0.53; 95% CI 0.40 to 0.66; donanemab ∆=0.66; 95% CI 0.41 to 0.91), whereas delayed-start cohorts showed no meaningful phase-related differences. OLE decline rates approximated those observed in DB placebo groups. In the lecanemab trial, DB placebo participants declined more slowly than matched untreated controls; decline in the donanemab trial varied by baseline severity.

CONCLUSIONS: Despite selective retention favouring slower progressors, both lecanemab and donanemab accelerated cognitive decline during OLE phases and paralleled placebo-level declines.

RevDate: 2026-08-16
CmpDate: 2026-08-15

Murugadoss K, Venkatakrishnan AJ, V Soundararajan (2026)

GLP-1-based incretin therapy is associated with lower incident Alzheimer's disease and cardiorenal events in adults with documented neuropsychiatric, cognitive, or sensory risk.

Biology methods & protocols, 11(1):bpag043.

Alzheimer's disease (AD) develops over years, creating an opportunity for interventions that target modifiable risk factors before the onset of clinical dementia. Here we applied a federated electronic health record (EHR) system encompassing over 29 million de-identified patients toward a target-trial emulation framework involving 153,412 adults aged 50 years or older with at least one documented AD risk factor. New users of glucagon-like peptide-1 (GLP-1)-based incretin therapy were compared with new users of non-GLP-1 antidiabetic medications after a 12-month washout, with 1:1 propensity-score matching on 30 baseline variables and additional exact matching on index year of therapy initiation and 5-year age band. In the primary matched cohort, 28,901 patients per arm, incretin initiation was associated with lower first recorded AD diagnosis (hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.29-0.73, q = 0.003), all-cause dementia (HR 0.66 [0.55-0.79], q < 0.001), and all-cause mortality (HR 0.46 [0.37-0.58], q < 0.001), with directionally-lower Mild Cognitive Impairment (HR 0.76 [0.61-0.94], q = 0.135) and Alzheimer's-related medication initiation (HR 0.82 [0.65-1.03], q = 0.217). The AD diagnosis mitigation signal was independently reproduced for semaglutide (HR 0.56; N = 23,675 per arm; q = 0.02), with the directionally consistent tirzepatide point estimate (HR 0.60) not reaching significance. GLP-1 RA initiation was also associated with substantially lower (all q < 0.001) incidence of heart failure (HR 0.50 [0.45-0.55]), cardiomyopathy (HR 0.38 [0.31-0.47]), major adverse cardiovascular events (HR 0.74 [0.67-0.82]), acute kidney injury (HR 0.67 [0.67-0.74]), and chronic kidney disease (HR 0.68 [0.62-0.75]). Negative-control outcomes showed no significant separation (all q > 0.45), including allergic rhinitis (HR 0.96 [0.87-1.07]), hemorrhoids (HR 1.07 [0.95-1.21]), and inguinal hernia (HR 1.39 [0.89-2.18]). Stricter two-code ICD definitions supported lower first recorded AD diagnosis in the incretin arm (HR 0.51 [0.29-0.89], q = 0.018) and lower first recorded all-cause dementia diagnosis (HR 0.68 [0.54-0.85], q = 0.003). In 12-month landmark analyses among semaglutide initiators, ≥5% weight-loss responders had lower 3-year AD cumulative incidence than non-responders after matching (0.07% vs. 0.40%; incidence ratio 5.76; P = .036), although this was not significant in the hazard-ratio model (HR 0.54, P = .39). Sustained-dose stratification showed no comparable gradient (high-dose vs. low-dose 0.30% vs. 0.14%; HR 2.77; P = .38), with ≤12 AD events per group. The weight-loss-specific pattern did not extend to all-cause dementia: weight-loss responders and non-responders had similar 3-year cumulative incidence (1.54% vs. 1.70%; HR 0.87, P = .53). Initiation of GLP-1 receptor agonist therapy in adults with documented AD risk factors was associated with lower recorded incidence of AD, dementia, mortality, and multiple cardiovascular and renal outcomes in this observational target-trial emulation. These findings support the hypothesis that earlier incretin therapy may contribute to AD risk modification through upstream cardiometabolic pathways, while prospective randomized prevention studies will be required to determine causality, underlying biological mechanisms, and optimal treatment timing.

RevDate: 2026-08-15
CmpDate: 2026-08-15

Anwer T, Verma A, Asiri A, et al (2026)

Restoration of Neuronal Metabolism and Memory in Alzheimer's Disease by Reprogramming the Exosomal microRNA Network.

Journal of molecular neuroscience : MN, 76(3):.

Historically the development of amyloid-β plaques and tau neurofibrillary tangles have been used as the hallmarks of Alzheimer's disease (AD). However, there is increasing evidence suggests that these pathological hallmarks are secondary to deeper metabolic defect in the brain. AD is progressively being recognized as a metabolic synaptic disorder characterized by insulin resistance, impaired cellular energy homeostasis, mitochondrial dysfunction, and synaptic degeneration. Synaptic plasticity is closely linked to the insulin-sensitive system of glucose utilization, mitochondrial activity, and local protein synthesis that render the synapses highly sensitive to the malfunction of the metabolic system. Recent discoveries highlight the important role of exosomes in mediating communication between neural cells by transferring regulatory miRNAs across neuronal networks. Exosomal miRNAs regulate insulin signaling, synaptic gene expression, mitochondrial function, and neuroinflammation. In AD, exosomal miRNA profiles are significantly altered, with enrichment of miR-29, miR-34a, miR-146a, and miR-21, alongside depletion of synapse-supporting miR-132. These changes contribute to insulin resistance, impaired glucose transporter trafficking, dendritic spine destabilization, and reduced expression of synaptic proteins such as PSD-95 and synaptophysin, ultimately leading to cognitive decline. Importantly, neuron-derived exosomes can cross the blood-brain barrier, making their miRNA cargo promising biomarkers and therapeutic targets for early AD diagnosis and precision treatment.

RevDate: 2026-08-15

Choi HS, Jeon SH, Liu H, et al (2026)

p53 deficiency increases vulnerability to chronic stress-induced anxiety- and depression-like behaviors: Role of calcium dysregulation and BDNF signaling.

Behavioural brain research pii:S0166-4328(26)00413-4 [Epub ahead of print].

The tumor suppressor protein p53 is a known modulator of neurodegenerative disease (ND) processes. Although p53 expression is increased in the brains of patients with Alzheimer's disease, Parkinson's disease, and ischemic stroke, its role in mood disorders such as anxiety and depression remains unclear. To investigate the role of p53 in behavioral responses to chronic stress, we examined behavioral and molecular alterations in p53 knockout (p53[-/-]) mice and wild type mice. In p53[-/-] mice, increased vulnerability to chronic unpredictable mild stress (CUMS)-induced anxiety- and depression-like behaviors was observed following CUMS exposure. In parallel with these behavioral changes, BDNF expression was reduced, whereas glutamate levels were elevated in the prefrontal cortex of p53[-/-] mice. Increased calcium-associated staining and NMDAR2B expression were observed together with increased neuronal injury- and cell death-related markers. In primary cortical neurons derived from p53[-/-] mice, corticosterone treatment resulted in greater increases in glutamate levels, NMDAR2B expression compared to wild-type controls. Cell death markers (cleaved caspase-3, p-p38, p-JNK) were upregulated, while neuroprotective signals (BDNF, p-Akt, p-ERK, p-CREB) were suppressed in p53[-/-] mice, and corticosterone-treated primary neuronal cells from p53[-/-] mice. These findings indicate that p53 deficiency is associated with enhanced vulnerability to CUMS-induced anxiety- and depression-like behaviors and is accompanied by alterations in calcium handling, glutamate homeostasis, neuronal injury-related markers, and BDNF-associated neuroprotective signaling.

RevDate: 2026-08-18
CmpDate: 2026-08-16

Bayly H, Salvati L, Lenio S, et al (2026)

Evaluating inclusion of continuous multivariable cognitive scores for operational enrichment of preclinical Alzheimer's disease trials: a retrospective emulation study.

JAR life, 15:100081.

BACKGROUND: Prevention trials for Alzheimer's Disease face significant challenges due to the slow and uncertain rate of cognitive decline in asymptomatic, amyloid-positive individuals. Biomarker positivity alone does not guarantee clinically meaningful progression, often leaving studies underpowered.

OBJECTIVES: Evaluate model-based operational trial enrichment within an amyloid-positive, cognitively normal subgroup.

METHODS: Trained on a small cohort from the National Alzheimer's Coordinating Center (N = 113), with external validation using baseline data of a similar small cohort from the Alzheimer's Disease Neuroimaging Initiative (N = 161). Gradient-boosted decision trees estimated progression risk and projected power under alternative enrollment strategies. Predictors included neuropsychological scores, demographics, medical history, and ApoE ε4 genotype. The primary outcome was clinical progression to cognitive impairment within 1- and 3-year follow-up windows.

RESULTS: In the independent testing set, the model successfully increased the effective prevalence of the outcome. The Positive Predictive Value for the 1-year window was 0.27 (a 35% relative increase over the 0.20 baseline prevalence) and 0.43 for the 3-year window (a 23% relative increase over the 0.35 baseline). Power simulations for an emulated trial (N = 500) demonstrated that this enrichment strategy consistently increased statistical power, potentially reducing the required sample size to achieve 80% power by up to 32% for small treatment effect sizes.

CONCLUSIONS: This operational methodology functions as a screening filter to optimize event rates within a highly specific, preselected trial population.

RevDate: 2026-08-17

Duijkers S, Ter Huurne DBG, Blom M, et al (2026)

Current Practice and Long-Term Developments in Multidisciplinary Dutch Memory Clinics.

Journal of geriatric psychiatry and neurology [Epub ahead of print].

ObjectivesMemory Clinics (MCs) have a central role in multidisciplinary diagnostics and care of cognitive disorders and dementia. This study describes current clinical practice and developments of Dutch MCs since their start in 1986.MethodsA survey was sent to all Dutch hospital-based MCs in 1998, 2004, 2009, 2017 and 2023. Topics included: organization, patient characteristics, scales and questionnaires, neuropsychological assessment, additional assessments, novel biomarkers, disclosure of diagnosis and treatment. 74 out of the total of 89 MCs completely or partially filled out the questionnaire.ResultsThe number of MCs increased to 89. The number of patients seen increased substantially (per MC/year: 1998: 130; 2023: 324; total: 1998: 1560; 2023: 28,848). The proportion of patients diagnosed with dementia decreased from 80% in 1998 to 47% in 2023. Most commonly available assessments were neuroimaging (100%), routine laboratory testing of blood (98%) and neuropsychological assessment (NPA; 98%). Thirty-one percent indicated infrastructure needed to be changed before prescribing monoclonal antibody treatments for Alzheimer's disease.ConclusionsMCs showed substantial development in number, number of patients and geographical distribution within the country. Nowadays, MCs are central care facilities for the timely and multidisciplinary diagnosis and treatment of people with cognitive disorders and dementia.

RevDate: 2026-08-17
CmpDate: 2026-08-17

Javed MN, Khan SM, Mustafa S, et al (2026)

Gantenerumab for Early Alzheimer's Disease: An Updated Systematic Review and Meta-Analysis.

Brain and behavior, 16(8):e71643.

INTRODUCTION: Alzheimer's disease (AD) is a progressive neurodegenerative disorder with limited treatment options. Gantenerumab, a β-amyloid-targeting monoclonal antibody, has shown mixed clinical results. With new trial data available, this updated systematic review and meta-analysis re-evaluates its efficacy and safety in early AD.

METHODS: Registered on PROSPERO (CRD420251082463) under PRISMA guidelines, we searched PubMed, Cochrane Library, and Google Scholar from inception to October 2025 for randomized trials in early AD comparing gantenerumab with placebo. A random-effects model assessed pooled outcomes with heterogeneity (I[2]) and sensitivity analyses. Additionally, meta-regression and certainty of evidence using Gradepro were performed. Risk of bias was evaluated using the Cochrane tool. An Institutional Review Committee (IRC) and its Ethical Review Board (ERB) approval was not required.

RESULTS: Six trials (3103 participants: 1718 gantenerumab; 1385 placebo) were included. Gantenerumab showed no significant effect on CDR-SB (MD = -0.07; 95% CI: -0.34-0.20; p = 0.62; I[2] = 16%) but produced small improvements in FAQ (MD = -0.73; 95% CI: -1.30 to -0.17; p = 0.01; I[2] = 0%) and Amyloid-PET score (MD = -45.67; 95% CI: -88.09 to -3.24; p = 0.03; I[2] = 99%). While significant statistical improvement was seen in the ADAS-Cog13 score (MD = -0.95; 95% CI: -1.76 to -0.13; p = 0.02; I[2] = 0%), the effect sizes for both FAQ and ADAS-Cog13 fell below established MCID thresholds. MMSE and ADCS-ADL showed no significant differences. Safety analysis revealed higher risks of ARIA-E (RR = 5.51), ARIA-H (RR = 1.73), and injection site reactions (RR = 2.15), with no differences in other adverse events.

CONCLUSION: Gantenerumab significantly reduces amyloid and statistically improves select functional (FAQ) and cognitive (ADAS-Cog13) measures in early AD; however, these changes remain below accepted MCID thresholds, indicating a lack of true clinical meaningfulness. Combined with its failure to enhance global cognition and an increased ARIA risk, routine clinical use is not supported.

RevDate: 2026-08-17

Cheng L, Gong P, Su X, et al (2026)

miR-584-5p suppresses Aβ1-42-induced apoptosis in Alzheimer's disease cell model via targeting of HDAC1.

Acta neurologica Belgica [Epub ahead of print].

BACKGROUND: Alzheimer's disease (AD) represents a profoundly detrimental neurodegenerative disorder, and early diagnosis coupled with effective treatment remains a major clinical challenge. MicroRNAs (miRNAs) have emerged as key regulators associated with pathological processes in AD.

AIM: This study aimed to explore the expression pattern and the likely diagnostic value of miR-584-5p in AD, as well as its molecular mechanism of action in regulating β-amyloid (Aβ)-induced apoptosis.

METHODS: Peripheral blood samples from 90 AD patients and age- and sex-matched controls were examined using RT-qPCR. Correlation analyses of miR-584-5p expression with key AD biomarkers (Aβ42, tTau, pTau) were performed in AD patients. Following exposure to 5 µM Aβ1-42, SH-SY5Y cells were employed in subsequent functional experiments. Bioinformatics analysis, a dual-luciferase reporter assay, and negative correlation analysis of plasma samples were conducted to verify the target gene of miR-584-5p.

RESULTS: miR-584-5p was significantly downregulated in AD patients, and its expression correlated with Aβ42 (r = 0.665), total tau (tTau, r = -0.642), phosphorylated tau (pTau, r = -0.576), and Mini-Mental State Examination (MMSE) scores (r = 0.618), yielding an AUC of 0.864 in this single-center cohort. miR-584-5p overexpression inhibited 5 µM Aβ1-42-induced apoptosis in SH-SY5Y cells, an effect that was reversed by concurrent HDAC1 overexpression. Mechanistically, by targeting HDAC1, miR-584-5p modulates p53 acetylation and the Bcl-2/Bax pathway at the protein level.

CONCLUSIONS: miR-584-5p exerted neuroprotective effects via the miR-584-5p/HDAC1 axis, offering new insights into AD pathogenesis and suggesting this axis as a candidate for further preclinical investigation.

RevDate: 2026-08-17
CmpDate: 2026-08-17

Jaiswal C, Singh I, AK Singh (2026)

Fisetin Attenuates Amyloid-Beta-Induced Neurotoxicity in Human Neuroblastoma SH-SY5Y Cells: Integrating In Silico Target Prediction and In Vitro Validation.

Journal of biochemical and molecular toxicology, 40(9):e71076.

The accumulation of amyloid beta (Aβ) and tau tangles in the brain leads to Alzheimer's disease (AD). Fisetin, a natural flavonoid, is an antioxidant molecule, and its neuroprotective effects are not clearly understood. Therefore, attempts have been made to evaluate the neuroprotective effects of fisetin using in silico methods and an Aβ1-42-induced neurotoxicity model in human neuroblastoma SH-SY5Y cells. In silico studies demonstrated that fisetin binds strongly and with high stability to different proteins, such as ULK1 (autophagy marker), p21 (senescence/cell cycle marker), and synaptophysin (synaptic marker), which are responsible for maintaining brain health and are implicated in AD. Moreover, Aβ1-42 was also found to bind to these protein targets, indicating that Aβ1-42 and fisetin both target common binding sites. In vitro studies on SH-SY5Y cells further confirmed that fisetin promotes cell survival under the toxic effects of Aβ1-42. It reduced oxidative stress and restored the activities of ion channels, which were impaired by Aβ1-42 treatment. Fisetin increased antioxidant defense and restored the activity of molecules that control brain signals. Overall, fisetin acts on multiple targets to protect neurons by reducing oxidative damage, supporting ion channel activity, and inducing the autophagy process.

RevDate: 2026-08-17

Li X, Chen Z, Guan J, et al (2026)

Oral Administration of Melatonin Modulates Macrophage Polarization via Modulating the Vegf Signaling Pathway and Ameliorates Alzheimer's Disease in APP/PS1 Mice.

Brain research bulletin pii:S0361-9230(26)00375-8 [Epub ahead of print].

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder with a global prevalence, currently lacking effective treatments and posing a major public health challenge due to the burden it places on healthcare systems while affecting millions of people. Melatonin is a hormone with considerable potential for treating various neurodegenerative disorders, including AD. The mechanisms responsible for melatonin's therapeutic benefits in Alzheimer's disease (AD) require further elucidation. This study was designed to investigate the mechanisms by which melatonin exerts its effects in APP/PS1 mice.

METHODS: The Morris water maze was used to assess the performance of melatonin-treated APP/PS1 mice. Haematoxylin&Eosin and Nissl staining were conducted to observe the integrity of hippocampal neurons. Transcriptomic sequencing of hippocampal tissue was performed to identify differentially expressed genes, which were subjected to Gene Ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Immunofluorescence analysis was used to detect the levels of Cd16, Cd32, Cd68 and Cd206 in APP/PS1 mice. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR), immunoblotting, and immunohistochemistry were employed to validate the relative expression of Vegf, Flt1, and Kdr proteins.

RESULTS: In the Morris water maze, melatonin-treated APP/PS1 mice demonstrated a marked increase in platform crossings. Improved neuronal integrity in the hippocampus was observed through Haematoxylin&Eosin and Nissl staining. Transcriptomic sequencing of hippocampal tissue revealed 295 differentially expressed genes, which were significantly associated with 1091 GO terms and 30 KEGG pathways. Immunofluorescence analysis indicated that melatonin treatment notably reduced Cd16 and Cd32 levels while elevating Cd68 and Cd206 in APP/PS1 mice. Subsequent analyses via RT-qPCR, immunoblotting, and immunohistochemistry validated the increased relative expression of Vegf, Flt1, and Kdr proteins.

DISCUSSION: Melatonin attenuates AD pathogenesis in APP/PS1 mice by promoting macrophage polarization via the Vegf signaling pathway, revealing a novel mechanism for AD prevention and treatment.

RevDate: 2026-08-18

Wu YL, Xu QQ, Qin ZH, et al (2026)

Oxyberberine-nanoparticle attenuates the cognitive deficits in a transgenic mouse model of Alzheimer's disease via modulating gut microbiota through suppressing CXCL10/CXCR3 pathway.

Acta pharmacologica Sinica [Epub ahead of print].

Oxyberberine (OBB) has good potential neuroprotective effects. However, the poor water solubility of OBB poses a challenge to its therapeutic effects. In this study, OBB-hydroxypropyl-β-cyclodextrin (OBB-β-CD) was prepared to increase the water solubility and improve bioavailability of OBB. The neuroprotective effects of OBB-β-CD against AD were investigated using 3×Tg transgenic AD mouse model. OBB-β-CD exhibited dual regulatory capabilities in improving both behavioral deficits and pathological features of AD. OBB-β-CD was more effective than OBB in modulating the amyloid precursor protein (APP) processing and inhibiting the hyperphosphorylation of Tau protein. OBB-β-CD was effective in reducing both the concentration of beta-amyloid 42 (Aβ42) and the deposition of Aβ plaques in 3×Tg mouse models. OBB-β-CD also suppressed neuroinflammation by promoting microglial polarization from an M1-like to an M2-like phenotype. Furthermore, OBB-β-CD restored the gut dysbiosis and inhibited the activation of the C-X-C motif chemokine receptor 3 (CXCR3) and the level of C-X-C motif chemokine ligand 10 (CXCL10) in the brain and colon tissues of 3×Tg mice. Simultaneously, the effect of OBB that suppressed microglial M1 and promoted M2 polarization to improve the neuronal micro-environment was verified in vitro using BV-2 cells. Importantly, OBB-β-CD showed similar anti-AD effects of knockdown of CXCR3 in 3×Tg mice, but no synergistic effects were observed in the shCXCR3 + OBB-β-CD group compared to the shCXCR3 group. Furthermore, the results of molecular docking and surface plasmon resonance (SPR) assay indicated that CXCR3 could bind with OBB. Additionally, the fecal microbiota transplantation (FMT) of fecal microbiota from the OBB-β-CD-treated 3×Tg mice (OBB-β-CD-FMT) significantly alleviated the cognitive deficits in the pseudo-germ-free 3×Tg mice via markedly suppressing the hyperphosphorylation of Tau protein, Aβ level and the activation of CXCR3 in the brain of 3×Tg mice. OBB-β-CD has good potential for further development into a therapeutic agent for AD treatment.

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RJR Experience and Expertise

Researcher

Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.

Educator

Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.

Administrator

Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.

Technologist

Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.

Publisher

While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.

Speaker

Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.

Facilitator

Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.

Designer

Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.

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